Provider Demographics
NPI:1467766493
Name:SHEA, PATRICK ALAN (MS, MSW)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:ALAN
Last Name:SHEA
Suffix:
Gender:M
Credentials:MS, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N FINDLEY ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:PUNXSUTAWNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15767-2049
Mailing Address - Country:US
Mailing Address - Phone:814-938-4408
Mailing Address - Fax:814-690-1850
Practice Address - Street 1:111 N FINDLEY ST
Practice Address - Street 2:SUITE A
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-2049
Practice Address - Country:US
Practice Address - Phone:814-938-4408
Practice Address - Fax:814-690-1850
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW127962104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker