Provider Demographics
NPI:1871558841
Name:SHEETS, WILLARD A (LPC)
Entity type:Individual
Prefix:MR
First Name:WILLARD
Middle Name:A
Last Name:SHEETS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 COURTHOUSE DRIVE P.O. BOX 299
Mailing Address - Street 2:PRESTERA CENTER
Mailing Address - City:WINFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:25213-9370
Mailing Address - Country:US
Mailing Address - Phone:304-525-7851
Mailing Address - Fax:304-586-0671
Practice Address - Street 1:3375 US RT 60 E
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-2837
Practice Address - Country:US
Practice Address - Phone:304-525-7851
Practice Address - Fax:304-586-0671
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE4195101YP2500X
WV2210101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0253701Medicaid
WV0005355002Medicaid
WV0005355002Medicaid