Provider Demographics
NPI:1538237896
Name:HEERMANCE, SHARON PAULSHOCK (PHD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:PAULSHOCK
Last Name:HEERMANCE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 SELKIRK RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-5659
Mailing Address - Country:US
Mailing Address - Phone:781-641-2974
Mailing Address - Fax:
Practice Address - Street 1:7 MYSTIC ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-1136
Practice Address - Country:US
Practice Address - Phone:617-966-0342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7036103T00000X, 103TF0000X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW05551OtherBLUE CROSS BLUE SHIELD