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General NPI Number Information
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NPI Number | 1831755818
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Entity Type | Individual
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Provider Name | PATRICE L SHEA RN, CDP, C-BCS,
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Gender | Female
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Dates
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Enumeration Date | 05/14/2019
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 1107 SENECA CREEK RD
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City | WEST SENECA
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State | NY
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Zip | 14224-2437
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Country | US
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Telephone | 716-674-1782
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Fax |
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Provider Business Mailing Address
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Address Line | 1107 SENECA CREEK RD
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City | WEST SENECA
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State | NY
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Zip | 14224-2437
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 163WN0800X
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Taxonomy Name | Neuroscience Registered Nurse
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License Number | 1831755818
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License Number State | NY
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Taxonomy #8
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State | NY
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Taxonomy #12
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number | 4801015243
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License Number State | MI
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