Healthcare Provider Details

I. General information

NPI: 1639644743
Provider Name (Legal Business Name): EMILY MARIE SHEEHAN MT-BC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2018
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 GLENSIDE AVE # 171
WYNCOTE PA
19095-1512
US

IV. Provider business mailing address

207 GLENSIDE AVE # 171
WYNCOTE PA
19095-1512
US

V. Phone/Fax

Practice location:
  • Phone: 484-483-6503
  • Fax:
Mailing address:
  • Phone: 484-483-6503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC009931
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: