Provider Demographics
NPI:1750525143
Name:SHEA, MEGHAN ELIZABETH
Entity type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:SHEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 COMMERCE PARK N STE 1A
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6951
Mailing Address - Country:US
Mailing Address - Phone:603-606-1233
Mailing Address - Fax:603-606-1233
Practice Address - Street 1:10 COMMERCE PARK N STE 1A
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6951
Practice Address - Country:US
Practice Address - Phone:603-606-1233
Practice Address - Fax:603-606-1233
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH16841041C0700X
NH0820101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)