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General NPI Number Information
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NPI Number | 1154725455
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Entity Type | Organization
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Legal Business Name | SHEEHAN BEHAVIORAL CONSULTANTS LLC
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Dates
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Enumeration Date | 10/15/2014
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Last Update Date | 10/15/2014
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Provider Practice Location Address
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Address Line | 13625 LARAMIE AVE
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City | CRESTWOOD
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State | IL
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Zip | 60445-1566
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Country | US
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Telephone | 708-837-3843
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Fax |
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Provider Business Mailing Address
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Address Line | 13625 LARAMIE AVE
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City | CRESTWOOD
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State | IL
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Zip | 60445-1566
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Country | US
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Telephone | 708-837-3843
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Fax |
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Authorized Official
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Title or Position | BOARD CERTIFIED BEHAVIOR ANALYST
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Name | COLLEEN LYNNE SHEEHAN
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Credential | BCBA
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Telephone | 708-837-3843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1-12-12059
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 1-12-12059
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License Number State | IL
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