MEDICARE: NANCY SHEEHAN LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174V00000X	Clinical Ethicist
2	101YM0800X	Mental Health Counselor	007233	NY

General Provider Information

NPI Number	:	1841696994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY SHEEHAN LMHC

Provider Business Mailing Address
First Line	:	500 8TH AVE
Second Line	:	902
City	:	NEW YORK
State	:	NY
Zip	:	10018-6504
Country	:	US
Telephone Number	:	212-679-4960
Fax Number	:	212-399-8902

Provider Business Practice Location Address
First Line	:	683 LEVERETT AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-2044
Country	:	US
Telephone Number	:	917-620-8408
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2014
Last Update Date	:	09/28/2022

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