Provider Demographics
NPI:1003003930
Name:BEHAN, SEAN M (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:M
Last Name:BEHAN
Suffix:
Gender:M
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 FITZWATERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1927
Mailing Address - Country:US
Mailing Address - Phone:215-658-4550
Mailing Address - Fax:215-658-4551
Practice Address - Street 1:630 FITZWATERTOWN RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1927
Practice Address - Country:US
Practice Address - Phone:215-658-4550
Practice Address - Fax:215-658-4551
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
PAPC008035101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC008035OtherSTATE LICENSE