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General NPI Number Information
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NPI Number | 1720739824
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Entity Type | Individual
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Provider Name | EHSAN ADIB SHABAHANG MS, LPC, LMHC, NCC
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Gender | Male
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Dates
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Enumeration Date | 01/11/2022
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 68 HARRISON AVE STE 605 PMB 866561
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City | BOSTON
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State | MA
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Zip | 02111-1929
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Country | US
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Telephone | 832-850-1283
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Fax |
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Provider Business Mailing Address
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Address Line | 68 HARRISON AVE STE 605 PMB 866561
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City | BOSTON
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State | MA
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Zip | 02111-1929
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Country | US
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Telephone | 832-850-1283
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 20487
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 10003605
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 88146
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 10501
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401224763
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License Number State | MI
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