Doctor Name: | MR. R KEVIN SHEEHAN |
NPI Number: | 1063463867 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.C.S.W. |
License Number: | 005832 |
Business Practice Address: | 165 State St Suite 200 New London, CT - 063206397 |
Business Phone Number: | 8604430036 |
Business Fax Number: | 8604434284 |
Mailing Address: | 165 State St, Suite 200 NEW LONDON |
State: | CT |
Postal Code: | 063206397 |
Phone Number: | 8604430036 |
Fax Number: | 8604434284 |
NPI Enumeration Date: | 05/15/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 005832 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |