Provider Demographics
NPI:1043808983
Name:COMPTON, SHEILA (LCSW)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:COMPTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 KELLY LN
Mailing Address - Street 2:
Mailing Address - City:BUMPASS
Mailing Address - State:VA
Mailing Address - Zip Code:23024-3448
Mailing Address - Country:US
Mailing Address - Phone:254-855-4918
Mailing Address - Fax:
Practice Address - Street 1:15255 MAX LEGGETT PKWY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-7273
Practice Address - Country:US
Practice Address - Phone:904-383-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040112621041C0700X
FL180301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical