Provider Demographics
NPI:1710433370
Name:TROTTER, SHEYLAH (BCBA, LMHC)
Entity Type:Individual
Prefix:
First Name:SHEYLAH
Middle Name:
Last Name:TROTTER
Suffix:
Gender:F
Credentials:BCBA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:867 BOYLSTON STREET, 5TH FLOOR #1226
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116
Mailing Address - Country:US
Mailing Address - Phone:857-400-8898
Mailing Address - Fax:
Practice Address - Street 1:867 BOYLSTON STREET
Practice Address - Street 2:5TH FLOOR #1226
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116
Practice Address - Country:US
Practice Address - Phone:857-400-8898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15348101YP2500X
103K00000X
MALMHC10000455101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst