Provider Demographics
NPI:1023737053
Name:SHEEHAN, NICOLE ELLEN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:ELLEN
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2646 SWART HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-9077
Mailing Address - Country:US
Mailing Address - Phone:607-267-5332
Mailing Address - Fax:
Practice Address - Street 1:2646 SWART HOLLOW RD
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-9077
Practice Address - Country:US
Practice Address - Phone:607-267-5332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116792-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker