Michael Robert Sheehan, PHD, HSPP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20010221A Issued in IN

Practice address

1230 Hillcrest Rd
South Bend, IN 46617-1169

Phone

(574) 232-2600

NPI assigned

Oct 11, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518055565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1771",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466341771",
            "telephone_number": "574-232-2600",
            "fax_number": "574-232-2627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 HILLCREST RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171169",
            "telephone_number": "574-232-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEHAN",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PHD, HSPP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20010221A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM/BCBS",
            "identifier": "000000191017",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "181379",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Collette Michelle Sharp
• Alice Catherine Shaw, FNP
• Aneesa Shaw
• Rebecca Shaw, RBT
• Clarice Shear, MA
• Kelly Elizabeth Sheets, LPC-MHSP
• Jasmine Shelby, LMHCA
• Shelly Overgaard, LCSW, LLC
• Anouk Danielle Shelton, MBA, RD, LD, CNSC
• Stephanie Ann Shemanski

• Clinical Psychologist in South Bend, IN
• Providers in South Bend, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.