Provider Demographics
NPI:1225628381
Name:SHEEHAN, BETH ANN (RBT)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-1314
Mailing Address - Country:US
Mailing Address - Phone:540-522-6331
Mailing Address - Fax:
Practice Address - Street 1:1215 W MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-4811
Practice Address - Country:US
Practice Address - Phone:804-355-0201
Practice Address - Fax:866-499-8840
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VARBT-20-132530106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician