Individual
GLENN D SHEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCP
Contact information
Practice address
6515 GEORGE WASHINGTON MEM HWY, STE 100, GRAFTON, VA 23692-2182
(757) 877-9140
(757) 877-3925
Mailing address
PO BOX 1069, GRAFTON, VA 23692-1069
(757) 877-9140
(757) 877-3925
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0107000605
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001979
VALUE OPTIONS
—
01
—
017162
ANTHEM
—
05
—
7746563
—
VA
Enumeration date
09/11/2006
Last updated
07/08/2007
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