| Katrina Shepard Licsw, Llc | |
|
165 Whitwell St Unit 2 Quincy MA 02169-1832 | |
| (617) 657-3425 | |
| Not Available |
| Full Name | Katrina Shepard Licsw, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 165 Whitwell St Unit 2, Quincy, Massachusetts |
| Authorized Official Name and Position | Katrina Shepard (OWNER) |
| Authorized Official Contact | 6176573425 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Katrina Shepard Licsw, Llc 165 Whitwell St Unit 2 Quincy MA 02169-1832 Ph: (617) 657-3425 | Katrina Shepard Licsw, Llc 165 Whitwell St Unit 2 Quincy MA 02169-1832 Ph: (617) 657-3425 |
| NPI Number | 1578137113 |
|---|---|
| Provider Enumeration Date | 05/18/2021 |
| Last Update Date | 05/18/2021 |
| Certification Date | 05/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578137113 | NPI | - | NPPES |
| 123451 | Other | MA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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