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General NPI Number Information
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NPI Number | 1053489732
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Entity Type | Individual
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Provider Name | ALBERT A SHIGO LICSW PHD
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Gender | Male
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 04/02/2008
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Provider Practice Location Address
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Address Line | 6 LONDONDERRY ROAD
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City | DERRY
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State | NH
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Zip | 03038
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Country | US
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Telephone | 603-370-0972
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Fax | 603-382-0386
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Provider Business Mailing Address
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Address Line | 2 VILLAGE GREEN RD STE BS
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City | HAMPSTEAD
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State | NH
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Zip | 03841-5209
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Country | US
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Telephone | 603-382-4741
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Fax | 603-329-6421
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 107
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 106093
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License Number State | MA
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