MEDICARE: SHANNA T FISHEL LICSW

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	1041C0700X	Clinical Social Worker	125188	MA

General Provider Information

NPI Number	:	1336868009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNA T FISHEL LICSW

Provider Business Mailing Address
First Line	:	236 CHESTERFIELD RD
Second Line	:
City	:	LEEDS
State	:	MA
Zip	:	01053-9772
Country	:	US
Telephone Number	:	413-561-7270
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 PLEASANT ST STE 320
Second Line	:
City	:	EASTHAMPTON
State	:	MA
Zip	:	01027-2756
Country	:	US
Telephone Number	:	415-561-7270
Fax Number	:

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

Provider Enumeration Date	:	08/25/2022
Last Update Date	:	12/23/2024

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Directions to “ SHANNA T FISHEL LICSW” Practice Location

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