Provider Demographics
NPI:1619225968
Name:SHEA, LEAH NOELLE
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:NOELLE
Last Name:SHEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2130
Mailing Address - Country:US
Mailing Address - Phone:508-243-6332
Mailing Address - Fax:
Practice Address - Street 1:27 2ND ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2130
Practice Address - Country:US
Practice Address - Phone:508-243-6332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health