MEDICARE: SHAQUAN READ COUNSELING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1225594203	OTHER	MA	NPI

General Provider Information

NPI Number	:	1619430212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHAQUAN READ COUNSELING, LLC

Provider Business Mailing Address
First Line	:	259 W MAIN ST
Second Line	:
City	:	WESTBOROUGH
State	:	MA
Zip	:	01581-3819
Country	:	US
Telephone Number	:	914-850-0640
Fax Number	:

Provider Business Practice Location Address
First Line	:	57 E MAIN ST STE 215
Second Line	:
City	:	WESTBOROUGH
State	:	MA
Zip	:	01581-1457
Country	:	US
Telephone Number	:	508-333-9161
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. SHAQUAN READ
Credential	:	LMHC
Telephone Number	:	914-850-0640

Provider Enumeration Date	:	04/10/2019
Last Update Date	:	04/11/2019

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