Provider Demographics
NPI:1871950477
Name:HALLIGAN, SHELLEY VICTORIA (PMHNP)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:VICTORIA
Last Name:HALLIGAN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-1149
Mailing Address - Country:US
Mailing Address - Phone:203-779-5799
Mailing Address - Fax:203-421-6830
Practice Address - Street 1:556 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-1149
Practice Address - Country:US
Practice Address - Phone:203-779-5799
Practice Address - Fax:203-421-6830
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT076207163WP0809X
CT7829363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult