Provider Demographics
NPI:1144785494
Name:AMY SHEERAN LLC
Entity Type:Organization
Organization Name:AMY SHEERAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEERAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:513-614-9625
Mailing Address - Street 1:9600 COLERAIN AVE STE 410
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-2016
Mailing Address - Country:US
Mailing Address - Phone:513-614-9625
Mailing Address - Fax:
Practice Address - Street 1:9600 COLERAIN AVE STE 410
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-2016
Practice Address - Country:US
Practice Address - Phone:513-614-9625
Practice Address - Fax:513-386-9473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0294595Medicaid