1912515701 NPI number — ANNE WHITNEY SHEA LPC

Table of content: ANNE WHITNEY SHEA LPC (NPI 1912515701)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912515701 NPI number — ANNE WHITNEY SHEA LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHEA
Provider First Name:
ANNE
Provider Middle Name:
WHITNEY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHEA
Provider Other First Name:
A.
Provider Other Middle Name:
WHITNEY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1912515701
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/07/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UNIT 5260 BOX 84
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DPO
Provider Business Mailing Address State Name:
AE
Provider Business Mailing Address Postal Code:
09759-0084
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-249-1720
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
141B STRADA EROU IANCU NICOLAE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VOLUNTARI
Provider Business Practice Location Address State Name:
BUCHAREST
Provider Business Practice Location Address Postal Code:
077190
Provider Business Practice Location Address Country Code:
RO
Provider Business Practice Location Address Telephone Number:
860-249-1720
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/17/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  364 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 4499 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)