Provider Demographics
NPI:1073011813
Name:SHEEHY, MAURA
Entity Type:Individual
Prefix:MS
First Name:MAURA
Middle Name:
Last Name:SHEEHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 COURT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-4103
Mailing Address - Country:US
Mailing Address - Phone:917-597-7991
Mailing Address - Fax:
Practice Address - Street 1:401 COURT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-4103
Practice Address - Country:US
Practice Address - Phone:917-597-7991
Practice Address - Fax:917-597-7991
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR072740-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical