Provider Demographics
NPI:1710160478
Name:SHEA, DONNA A (MA,LMHC)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:A
Last Name:SHEA
Suffix:
Gender:F
Credentials:MA,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 MERRIMACK ST
Mailing Address - Street 2:SUITE 512
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6112
Mailing Address - Country:US
Mailing Address - Phone:603-921-7025
Mailing Address - Fax:978-478-6369
Practice Address - Street 1:191 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6112
Practice Address - Country:US
Practice Address - Phone:603-921-7025
Practice Address - Fax:978-478-6369
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8606101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1004745OtherNHP
MAM18633OtherBCBS
MA703136OtherTUFTS
MAY10074Medicare UPIN
MA00000023532OtherBMC
MA1303287OtherMBHP
MA1303287Medicaid