Provider Demographics
NPI:1356986236
Name:MCCANN, SEAN (LPC)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:MCCANN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2542 GRAYS FERRY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-2331
Mailing Address - Country:US
Mailing Address - Phone:215-688-0042
Mailing Address - Fax:
Practice Address - Street 1:135 S 19TH ST # 350B
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-4912
Practice Address - Country:US
Practice Address - Phone:215-285-1084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011709101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional