Shea, Edward J.
Shea, Edward J. is an individual health care provider with primary practice located at 200 Pulver Hall , Dickinson ND 58601-4878. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Shea, Edward J. can be contacted via phone (701) 227-7580.Contact Information
Primary practice address
200 Pulver Hall
Dickinson ND 58601-4878
Phone: (701) 227-7580
Fax: (701) 227-7575
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 1114 | North Dakota |
Profile Details
| NPI number | 1891718672 |
|---|---|
| LBN Legal business name | Shea, Edward J. |
| Credentials | MA, LAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 25th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891718672 | NPPES |
| North Dakota | MEDICAID | 54523 | |
| North Dakota | Other | 09113 |
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