Provider Demographics
NPI:1497294680
Name:ALEXIS, SHEEBAH (BCBA)
Entity type:Individual
Prefix:
First Name:SHEEBAH
Middle Name:
Last Name:ALEXIS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:SHEEBAH
Other - Middle Name:
Other - Last Name:VOLCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:198 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-2543
Mailing Address - Country:US
Mailing Address - Phone:617-276-4905
Mailing Address - Fax:
Practice Address - Street 1:198 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-2543
Practice Address - Country:US
Practice Address - Phone:617-276-4905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
MA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist