Provider Demographics
NPI:1992454342
Name:MCCANN, SHEA (MS OTR/L)
Entity type:Individual
Prefix:
First Name:SHEA
Middle Name:
Last Name:MCCANN
Suffix:
Gender:M
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3818 JOHN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-3208
Mailing Address - Country:US
Mailing Address - Phone:207-660-5715
Mailing Address - Fax:
Practice Address - Street 1:3570 WARRENSVILLE CENTER RD STE 106
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-5226
Practice Address - Country:US
Practice Address - Phone:216-282-1582
Practice Address - Fax:216-927-1801
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-22
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT012089225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist