Provider Demographics
NPI:1659520997
Name:SHEA, ROBERT RAMSEY (LMFT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:RAMSEY
Last Name:SHEA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 EXCHANGE BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14608-2755
Mailing Address - Country:US
Mailing Address - Phone:585-473-2671
Mailing Address - Fax:
Practice Address - Street 1:301 EXCHANGE BLVD STE 201
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14608-2755
Practice Address - Country:US
Practice Address - Phone:585-473-2671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY755101YA0400X
NY209106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)