Provider Demographics
NPI:1568718278
Name:DOOLEY, SHAUN CHRISTOPHER
Entity Type:Individual
Prefix:MR
First Name:SHAUN
Middle Name:CHRISTOPHER
Last Name:DOOLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2051 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33404-7004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2051 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:STE 101
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-7004
Practice Address - Country:US
Practice Address - Phone:561-683-4778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker