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General NPI Number Information
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NPI Number | 1821559691
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Entity Type | Individual
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Provider Name | MARY LEE SHEA PHD
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Gender | Female
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 2400 GREATSTONE PT FL 2
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City | LEXINGTON
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State | KY
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Zip | 40504-3274
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Country | US
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Telephone | 859-323-6211
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Fax | 859-257-7706
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Provider Business Mailing Address
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Address Line | 302 FORREST DR
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City | LAWRENCEBURG
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State | KY
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Zip | 40342-1341
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Country | US
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Telephone |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 295104
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License Number State | KY
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