Provider Demographics
NPI:1245044833
Name:SHERIDAN, LEAH MARJORIE (PMHNP)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:MARJORIE
Last Name:SHERIDAN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CUMMINGS CTR STE 206N
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6286
Mailing Address - Country:US
Mailing Address - Phone:888-646-0566
Mailing Address - Fax:
Practice Address - Street 1:100 CUMMINGS CTR STE 206N
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6286
Practice Address - Country:US
Practice Address - Phone:888-646-0566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2317172363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health