Provider Demographics
NPI:1043321839
Name:MANGAN, CATHERINE SHEEHAN (LISW)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:SHEEHAN
Last Name:MANGAN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3543 W 146TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-3108
Mailing Address - Country:US
Mailing Address - Phone:216-476-2848
Mailing Address - Fax:
Practice Address - Street 1:20325 CENTER RIDGE RD
Practice Address - Street 2:SUITE 628
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3572
Practice Address - Country:US
Practice Address - Phone:440-331-5570
Practice Address - Fax:440-331-3221
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-3281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical