Provider Demographics
NPI:1083257620
Name:CLEARY, SEAN DENNIN (MS, LPC, NCC)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:DENNIN
Last Name:CLEARY
Suffix:
Gender:M
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BALA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-3207
Mailing Address - Country:US
Mailing Address - Phone:610-405-5681
Mailing Address - Fax:
Practice Address - Street 1:1 BALA AVE STE 110
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-3207
Practice Address - Country:US
Practice Address - Phone:610-405-5681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-27
Last Update Date:2019-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011777101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health