Provider Demographics
NPI:1942533450
Name:DEMELLE, SHEILA HELEN (LICSW)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:HELEN
Last Name:DEMELLE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 TURNPIKE ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2865
Mailing Address - Country:US
Mailing Address - Phone:617-462-7283
Mailing Address - Fax:
Practice Address - Street 1:1032 TURNPIKE ST
Practice Address - Street 2:SUITE 204
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2865
Practice Address - Country:US
Practice Address - Phone:617-462-7283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10266451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical