Individual
DR. MICHAEL ROBERT SHEEHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, HSPP
Contact information
Practice address
1230 HILLCREST RD, SOUTH BEND, IN 46617-1169
(574) 232-2600
Mailing address
PO BOX 1771, SOUTH BEND, IN 46634-1771
(574) 232-2600
(574) 232-2627
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20010221A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000191017
ANTHEM/BCBS
IN
01
—
181379
VALUE OPTIONS
—
Enumeration date
10/11/2006
Last updated
07/08/2007
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