John E Shea, ED.D

Individual provider Active NPI Psychologist · Hampden, MA

NPI 1245366343 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1245366343
Entity type
Individual (NPI type 1)
Primary specialty
Psychologist 103T00000X
License
2236 (MA)
Practice address
11 Erica Cir
Hampden, MA 01036-9652
Phone
(413) 626-3748
Fax
(413) 566-5829
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2236MAMDChiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2236 MA Yes

Addresses

Primary practice location

11 Erica Cir
Hampden, MA 01036-9652

Mailing address

11 Erica Cir
Hampden, MA 01036-9652
Phone (413) 626-3748

Other providers in Hampden, MA

All providers in Hampden, MA · Psychologist in Massachusetts

Sources for this page

Verify at the official NPI Registry.