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NPI Code Detail

MEDICARE: SHANNON M BEHAN MSW

MEDICARE:   SHANNON M BEHAN  MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1225514862
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON M BEHAN MSW
Provider Business Mailing Address
First Line : 1274 CURRAN HWY
Second Line :
City : NORTH ADAMS
State : MA
Zip : 01247-3907
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1274 CURRAN HWY
Second Line :
City : NORTH ADAMS
State : MA
Zip : 01247-3907
Country : US
Telephone Number : 413-664-9024
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2018
Last Update Date : 07/17/2018

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