Logan, Shea

Logan, Shea is an individual health care provider with primary practice located at 80Th St & 41St Ave , Elmhurst NY 11373. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Logan, Shea can be contacted via phone (718) 334-5970.

Contact Information

Primary practice address
80Th St & 41St Ave Elmhurst NY 11373
Fax: (718) 334-5958
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X P49924 New York

Profile Details

NPI number 1598821050
LBN Legal business name Logan, Shea
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598821050 NPPES
New York MEDICAID 00246075

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