MEDICARE: SHEILA DAWN RUNNELS M.S., LPC, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	3114	MS

General Provider Information

NPI Number	:	1184390841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEILA DAWN RUNNELS M.S., LPC, NCC

Provider Business Mailing Address
First Line	:	112 LAKEVIEW DR
Second Line	:
City	:	CLINTON
State	:	MS
Zip	:	39056-4434
Country	:	US
Telephone Number	:	601-674-2844
Fax Number	:

Provider Business Practice Location Address
First Line	:	341 EDGEWOOD TERRACE DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39206-6217
Country	:	US
Telephone Number	:	601-487-6344
Fax Number	:	601-398-0289

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2021
Last Update Date	:	08/27/2025

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