MEDICARE: ANN L SHEEHAN LCSW

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	104100000X	Social Worker	R0199451	NY
2	1041C0700X	Clinical Social Worker	R019945	NY

General Provider Information

NPI Number	:	1346278249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN L SHEEHAN LCSW

Provider Business Mailing Address
First Line	:	94 JORALEMON ST APT 4
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-6602
Country	:	US
Telephone Number	:	212-691-1995
Fax Number	:	516-977-3266

Provider Business Practice Location Address
First Line	:	94 JORALEMON ST APT 4
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-6602
Country	:	US
Telephone Number	:	212-691-1995
Fax Number	:	516-977-3266

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

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	08/04/2023

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