Provider Demographics
NPI:1003128737
Name:SHEERAN, JAMES MICHAEL (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MICHAEL
Last Name:SHEERAN
Suffix:
Gender:M
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 1:171 ALDER ST.
Mailing Address - Street 2:CASA DEL SOUL ANNEX
Mailing Address - City:CRESTONE
Mailing Address - State:CO
Mailing Address - Zip Code:81131-0464
Mailing Address - Country:US
Mailing Address - Phone:719-588-9637
Mailing Address - Fax:719-256-5890
Practice Address - Street 1:171 ALDER ST.
Practice Address - Street 2:
Practice Address - City:CRESTONE
Practice Address - State:CO
Practice Address - Zip Code:81131-0464
Practice Address - Country:US
Practice Address - Phone:719-588-9637
Practice Address - Fax:719-256-5890
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5456101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional