Healthcare Provider Details

I. General information

NPI: 1265198402
Provider Name (Legal Business Name): SHEENA MARIA LOCKETTI MSN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2021
Last Update Date: 03/31/2022
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 MARMION AVE
YOUNGSTOWN OH
44502-2323
US

IV. Provider business mailing address

535 MARMION AVE
YOUNGSTOWN OH
44502-2323
US

V. Phone/Fax

Practice location:
  • Phone: 330-782-5664
  • Fax:
Mailing address:
  • Phone: 330-782-5664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0030208
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: