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Individual

J. MARK O'SHEA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
4906 MILLRIDGE PKWY E, MIDLOTHIAN, VA 23112-4828
(804) 744-5611
(804) 528-4937
Mailing address
4906 MILLRIDGE PKWY E, MIDLOTHIAN, VA 23112-4828
(804) 744-5611
(804) 528-4937

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904001638
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010026997
VA
01
142616
ANTHEM BLUE CROSS
VA
Enumeration date
07/19/2006
Last updated
04/28/2017
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