Basic Information
| Provider Information | |||||||||
| NPI: | 1306975099 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HESS | ||||||||
| FirstName: | SHELDON | ||||||||
| MiddleName: | PHILIP | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7433 CENTER ST | ||||||||
| Address2: | APT. 110 | ||||||||
| City: | MENTOR | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440605830 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4407492278 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8445 MUNSON RD | ||||||||
| Address2: | |||||||||
| City: | MENTOR | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440602410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402551700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | C-0005298 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.