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General NPI Number Information
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NPI Number | 1720521677
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Entity Type | Individual
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Provider Name | KATHERINE SHEEHAN LSW
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Gender | Female
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Dates
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Enumeration Date | 11/27/2016
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Last Update Date | 06/15/2020
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Provider Practice Location Address
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Address Line | 66 MILLER DR
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City | NORTH AURORA
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State | IL
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Zip | 60542-5143
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Country | US
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Telephone | 630-570-0050
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Fax |
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Provider Business Mailing Address
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Address Line | 1817 PLUM ST
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City | AURORA
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State | IL
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Zip | 60506-4315
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Country | US
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Telephone | 630-730-3816
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.103673
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-16-22093
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License Number State | IL
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