Provider Demographics
NPI:1750550893
Name:SHEEHAN, ROBERT LESTER (LCSW)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LESTER
Last Name:SHEEHAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-2550
Mailing Address - Country:US
Mailing Address - Phone:207-386-1800
Mailing Address - Fax:207-386-1801
Practice Address - Street 1:108 CENTRE ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-2550
Practice Address - Country:US
Practice Address - Phone:207-386-1800
Practice Address - Fax:207-386-1801
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-22
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC65471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEE400258934Medicare PIN