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General NPI Number Information
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NPI Number | 1205708252
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Entity Type | Organization
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Legal Business Name | VIVIAN A. SHELTON, PSY.D., LLC DBA EVOLUTIONARY WELLBEING
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 9 COTTAGE ST REAR
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City | MARION
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State | MA
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Zip | 02738-1530
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Country | US
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Telephone | 508-287-4887
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Fax | 571-730-3689
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Provider Business Mailing Address
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Address Line | PO BOX 119
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City | MARION
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State | MA
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Zip | 02738-0002
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Country | US
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Telephone | 508-287-4887
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Fax | 571-730-3689
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. VIVIAN ALLISON SHELTON
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Credential | PSY.D.
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Telephone | 703-475-6478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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