Healthcare Provider Details

I. General information

NPI: 1639080492
Provider Name (Legal Business Name): SECOND SHIFT CLINICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 MINOT ST
READING MA
01867-3538
US

IV. Provider business mailing address

19 MINOT ST
READING MA
01867-3538
US

V. Phone/Fax

Practice location:
  • Phone: 978-267-1609
  • Fax:
Mailing address:
  • Phone: 978-267-1609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SOPHIE HANSEN
Title or Position: OWNER
Credential: LICSW
Phone: 978-267-1609