Provider Demographics
NPI:1750657862
Name:SHEERAN, MARTIN ROBERT (LCMHC)
Entity type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:ROBERT
Last Name:SHEERAN
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:MR
Other - First Name:MARTIN
Other - Middle Name:ROBERT
Other - Last Name:SHEERAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCMHC
Mailing Address - Street 1:393 E RIVERSIDE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7124
Mailing Address - Country:US
Mailing Address - Phone:435-359-2364
Mailing Address - Fax:408-356-1742
Practice Address - Street 1:393 E RIVERSIDE DR STE 201
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7124
Practice Address - Country:US
Practice Address - Phone:435-359-2364
Practice Address - Fax:408-356-1742
Is Sole Proprietor?:No
Enumeration Date:2012-03-23
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8176271-6004101YM0800X
UT8176271-6009101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional