Provider Demographics
NPI:1750705471
Name:MARCZAK, SHEILA A (MMFT)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:A
Last Name:MARCZAK
Suffix:
Gender:F
Credentials:MMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 DEERFIELD LN
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-8768
Mailing Address - Country:US
Mailing Address - Phone:615-584-7848
Mailing Address - Fax:
Practice Address - Street 1:687C EMORY VALLEY RD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-7746
Practice Address - Country:US
Practice Address - Phone:865-498-9446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-17
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN988106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist