Provider Demographics
NPI:1023137296
Name:SHEA, DOLORES ANN (LMHC, MS)
Entity type:Individual
Prefix:
First Name:DOLORES
Middle Name:ANN
Last Name:SHEA
Suffix:
Gender:F
Credentials:LMHC, MS
Other - Prefix:
Other - First Name:DOLORES
Other - Middle Name:ANN
Other - Last Name:CRAIG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC, MS
Mailing Address - Street 1:51 BARTONS LANE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186
Mailing Address - Country:US
Mailing Address - Phone:617-504-3574
Mailing Address - Fax:617-690-2717
Practice Address - Street 1:51 BARTONS LANE
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186
Practice Address - Country:US
Practice Address - Phone:617-504-3574
Practice Address - Fax:617-690-2717
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YA0400X, 101YM0800X
MALMHC6712101YM0800X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)