Healthcare Provider Details

I. General information

NPI: 1871170316
Provider Name (Legal Business Name): ALEXIA SHEEHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 PHOENIX DR STE 150
VIRGINIA BEACH VA
23452-7341
US

IV. Provider business mailing address

193 OAK ST STE 1
NEWTON MA
02464-1453
US

V. Phone/Fax

Practice location:
  • Phone: 615-570-9959
  • Fax:
Mailing address:
  • Phone: 617-658-5611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: