Healthcare Provider Details

I. General information

NPI: 1477123248
Provider Name (Legal Business Name): THERAPY WITH SHELBY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2021
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 GARRISON AVE
SOMERVILLE MA
02144
US

IV. Provider business mailing address

1770 MASSACHUSETTS AVE # 116
CAMBRIDGE MA
02140-2808
US

V. Phone/Fax

Practice location:
  • Phone: 617-616-8491
  • Fax: 617-812-9379
Mailing address:
  • Phone: 617-616-8491
  • Fax: 617-812-9379

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: SHELBY KIRSCH DWYER
Title or Position: OWNER
Credential: LMHC
Phone: 617-616-8491