Provider Demographics
NPI:1689627804
Name:SHEEHAN, THOMAS FRANCIS JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FRANCIS
Last Name:SHEEHAN
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:F
Other - Last Name:SHEEHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:600 E WILLIAM ST STE 202
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-4085
Mailing Address - Country:US
Mailing Address - Phone:775-515-4163
Mailing Address - Fax:775-515-4164
Practice Address - Street 1:600 E WILLIAM ST STE 202
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701
Practice Address - Country:US
Practice Address - Phone:775-515-4163
Practice Address - Fax:775-831-2039
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY081103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002616000Medicaid