Healthcare Provider Details

I. General information

NPI: 1811815921
Provider Name (Legal Business Name): ASHLEY I SHEEHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 DUNDEE PARK DR STE 301
ANDOVER MA
01810-3725
US

IV. Provider business mailing address

21 STOUGHTON ST
MEDFORD MA
02155-4220
US

V. Phone/Fax

Practice location:
  • Phone: 978-396-9866
  • Fax:
Mailing address:
  • Phone: 781-803-0927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: