Individual
PHILIP R SHERIDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
161 COWCATCHER LOOP, BELLEVUE, ID 83313-5289
(801) 884-3809
Mailing address
161 COWCATCHER LOOP, BELLEVUE, ID 83313-5289
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LCSW-7671154
ID
1041C0700X
Clinical Social Worker
Primary
LCSW-7671154
ID
1041C0700X
Clinical Social Worker
LCSW24911
ID
Other
Enumeration date
07/14/2006
Last updated
08/29/2025
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