Provider Demographics
NPI:1558708313
Name:HEALEY, SEAN (PSYD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:HEALEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 THORN RUN RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-3102
Mailing Address - Country:US
Mailing Address - Phone:412-329-7778
Mailing Address - Fax:412-262-1555
Practice Address - Street 1:1150 THORN RUN ROAD
Practice Address - Street 2:SUITE 110
Practice Address - City:MOON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15108
Practice Address - Country:US
Practice Address - Phone:412-329-7778
Practice Address - Fax:412-262-1555
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC-006965101YP2500X
PAPS017691103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional