Healthcare Provider Details

I. General information

NPI: 1346964996
Provider Name (Legal Business Name): SHELBY CURRAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2022
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 MAIN ST STE 222
CHARLESTOWN MA
02129-1101
US

IV. Provider business mailing address

529 MAIN ST STE 222
CHARLESTOWN MA
02129-1101
US

V. Phone/Fax

Practice location:
  • Phone: 866-610-2273
  • Fax:
Mailing address:
  • Phone: 866-610-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number226602
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: