Provider Demographics
NPI:1417608225
Name:SHEEHY, MARIN E (MS, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:MARIN
Middle Name:E
Last Name:SHEEHY
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 GWYNNS MILL CT STE I
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3528
Mailing Address - Country:US
Mailing Address - Phone:410-849-9496
Mailing Address - Fax:
Practice Address - Street 1:7 GWYNNS MILL CT STE I
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3528
Practice Address - Country:US
Practice Address - Phone:410-849-9496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
MDLBA2010103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician