Healthcare Provider Details

I. General information

NPI: 1003359050
Provider Name (Legal Business Name): SHEILA M. DALEY, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2016
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FIRST AVENUE NW SUITE 210
ROCHESTER MN
55901
US

IV. Provider business mailing address

407 EAGLE LANE SW
ROCHESTER MN
55902
US

V. Phone/Fax

Practice location:
  • Phone: 507-273-2034
  • Fax: 507-424-1052
Mailing address:
  • Phone: 507-273-2034
  • Fax: 507-424-1052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberLP4617
License Number StateMN

VIII. Authorized Official

Name: SHEILA MARIE DALEY
Title or Position: PRESIDENT
Credential: MA, LP, LMFT
Phone: 507-273-2034