Healthcare Provider Details

I. General information

NPI: 1831487727
Provider Name (Legal Business Name): JESSICA PAIGE STUART-SHOR PMHNP, RN, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. JESSICA PAIGE WESTER

II. Dates (important events)

Enumeration Date: 07/13/2011
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 TUFTS ST
CHARLESTOWN MA
02129-2711
US

IV. Provider business mailing address

36 1ST AVE
CHARLESTOWN MA
02129-4557
US

V. Phone/Fax

Practice location:
  • Phone: 857-238-1100
  • Fax:
Mailing address:
  • Phone: 617-726-2947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2390992
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8627
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN2390992
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: