MEDICARE: LAUREN MARIE SHEA

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	218889	MA
2	101YM0800X	Mental Health Counselor
3	101YM0800X	Mental Health Counselor	5658	CT

General Provider Information

NPI Number	:	1740561257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN MARIE SHEA

Provider Business Mailing Address
First Line	:	189 NEW SWEDEN RD
Second Line	:
City	:	WOODSTOCK
State	:	CT
Zip	:	06281-3215
Country	:	US
Telephone Number	:	860-481-2750
Fax Number	:

Provider Business Practice Location Address
First Line	:	189 NEW SWEDEN RD
Second Line	:
City	:	WOODSTOCK
State	:	CT
Zip	:	06281-3215
Country	:	US
Telephone Number	:	860-481-2750
Fax Number	:

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

Provider Enumeration Date	:	08/30/2011
Last Update Date	:	02/23/2023

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Directions to “ LAUREN MARIE SHEA ” Practice Location

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