Provider Demographics
NPI:1760362040
Name:SHEA, CHLOE JAMES
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:JAMES
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 1:104 BARR LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-4940
Mailing Address - Country:US
Mailing Address - Phone:914-236-0692
Mailing Address - Fax:
Practice Address - Street 1:237 MAMARONECK AVE STE 200
Practice Address - Street 2:SUITE 200
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1318
Practice Address - Country:US
Practice Address - Phone:914-236-0692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty