Provider Demographics
NPI:1639327141
Name:SHEA, MARY CAITLIN (MSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:CAITLIN
Last Name:SHEA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CUMMINGS CTR
Mailing Address - Street 2:SUITE 266T
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6175
Mailing Address - Country:US
Mailing Address - Phone:978-921-1190
Mailing Address - Fax:978-927-3724
Practice Address - Street 1:800 CUMMINGS CTR
Practice Address - Street 2:SUITE 266T
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6175
Practice Address - Country:US
Practice Address - Phone:978-921-1190
Practice Address - Fax:978-927-3724
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical