Provider Demographics
NPI:1326697533
Name:SHEEHAN, KATHRYN (MA, MS, ATC)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:MA, MS, ATC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:SHEEHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:48 N PLEASANT ST STE 207
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1758
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:48 N PLEASANT ST STE 207
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-1758
Practice Address - Country:US
Practice Address - Phone:413-200-8024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-10
Last Update Date:2024-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2255A2300X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty