Healthcare Provider Details

I. General information

NPI: 1417869603
Provider Name (Legal Business Name): BRYNA COFRIN-SHAW LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 MOUNTAIN ST
FLORENCE MA
01062-1065
US

IV. Provider business mailing address

97 MOUNTAIN ST
FLORENCE MA
01062-1065
US

V. Phone/Fax

Practice location:
  • Phone: 413-247-4471
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10005924
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: