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General NPI Number Information
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NPI Number | 1831471747
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Entity Type | Individual
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Provider Name | SHANNA HEBERT LCSW, LICSW
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Gender | Female
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Dates
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Enumeration Date | 09/16/2011
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 264 N MAIN ST STE 10
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City | EAST LONGMEADOW
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State | MA
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Zip | 01028-1837
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Country | US
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Telephone | 860-461-7792
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Fax |
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Provider Business Mailing Address
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Address Line | 24 PEARL ST
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City | MANCHESTER
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State | CT
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Zip | 06040-5310
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Country | US
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Telephone | 413-200-2366
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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