Provider Demographics
NPI:1376936401
Name:SHEELA BEHAVIORAL CONSULTING LLC
Entity Type:Organization
Organization Name:SHEELA BEHAVIORAL CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE MOTHER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEELA
Authorized Official - Middle Name:D
Authorized Official - Last Name:TALLAMRAJU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-906-4353
Mailing Address - Street 1:69 BILOTTA WAY
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-4881
Mailing Address - Country:US
Mailing Address - Phone:978-906-4353
Mailing Address - Fax:
Practice Address - Street 1:344 MAIN ST
Practice Address - Street 2:SUITE NUMBER 11
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-8007
Practice Address - Country:US
Practice Address - Phone:978-906-4353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-13
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health