Healthcare Provider Details

I. General information

NPI: 1780559419
Provider Name (Legal Business Name): SOPHIA ANGELINA SHEEHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 UNION ST STE 3
WORCESTER MA
01608-1141
US

IV. Provider business mailing address

25 UNION ST STE 3
WORCESTER MA
01608-1141
US

V. Phone/Fax

Practice location:
  • Phone: 508-317-2323
  • Fax:
Mailing address:
  • Phone: 508-317-2323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: