Provider Demographics
NPI:1699865766
Name:O'SHEA, LINDA M (MA LPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:O'SHEA
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-5140
Mailing Address - Country:US
Mailing Address - Phone:970-346-9057
Mailing Address - Fax:970-378-2506
Practice Address - Street 1:3400 W 16TH ST
Practice Address - Street 2:BLDG 6 STE K
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-6862
Practice Address - Country:US
Practice Address - Phone:970-346-9057
Practice Address - Fax:970-378-2506
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO443101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional