Provider Demographics
NPI:1811587124
Name:SHEEHAN, JANA (LSWAIC)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:JANA
Other - Middle Name:
Other - Last Name:GREER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:34115 CANTERA ST
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-9207
Mailing Address - Country:US
Mailing Address - Phone:509-554-9423
Mailing Address - Fax:
Practice Address - Street 1:34115 CANTERA ST
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-9207
Practice Address - Country:US
Practice Address - Phone:509-554-9423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61120345101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health