MEDICARE: SHAINA ROSE FUSCO

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1275472037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAINA ROSE FUSCO

Provider Business Mailing Address
First Line	:	50 TOWER OFFICE PARK
Second Line	:
City	:	WOBURN
State	:	MA
Zip	:	01801-2113
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 TOWER OFFICE PARK
Second Line	:
City	:	WOBURN
State	:	MA
Zip	:	01801-2113
Country	:	US
Telephone Number	:	781-476-1645
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2026
Last Update Date	:	03/26/2026

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Directions to “ SHAINA ROSE FUSCO ” Practice Location

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