Provider Demographics
NPI:1114018272
Name:MAHER, SHEILA (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:
Last Name:MAHER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 CONCORD AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1337
Mailing Address - Country:US
Mailing Address - Phone:617-497-9139
Mailing Address - Fax:617-441-2590
Practice Address - Street 1:240 CONCORD AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1337
Practice Address - Country:US
Practice Address - Phone:617-497-9139
Practice Address - Fax:617-441-2590
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3511103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW03600Medicare UPIN
MAW03600Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER