Provider Demographics
NPI:1962762211
Name:SHEEHAN, CATHERINE (MA, CAP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:MA, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 152465
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33915-2465
Mailing Address - Country:US
Mailing Address - Phone:239-462-5016
Mailing Address - Fax:239-542-4322
Practice Address - Street 1:4002 OASIS BLVD
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-5448
Practice Address - Country:US
Practice Address - Phone:239-462-5016
Practice Address - Fax:239-542-4322
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4831101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)