Healthcare Provider Details

I. General information

NPI: 1720568157
Provider Name (Legal Business Name): SHAREVISION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2018
Last Update Date: 01/13/2022
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 RUSSELL ST STE 1
HADLEY MA
01035-5912
US

IV. Provider business mailing address

PO BOX 3444
AMHERST MA
01004-3444
US

V. Phone/Fax

Practice location:
  • Phone: 413-586-5800
  • Fax: 413-256-3434
Mailing address:
  • Phone: 413-588-5800
  • Fax: 413-258-3434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1020713
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number813
License Number StateMA

VIII. Authorized Official

Name: DR. LISA D THOMPSON
Title or Position: CEO, EXECUTIVE DIRECTOR
Credential: EDD LICSW
Phone: 413-221-4625