Provider Demographics
NPI:1174697817
Name:MCSHANE, CAROL ANN (MSW)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:ANN
Last Name:MCSHANE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:FERRIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:309 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2946
Mailing Address - Country:US
Mailing Address - Phone:781-444-3245
Mailing Address - Fax:
Practice Address - Street 1:125 HIGH ST
Practice Address - Street 2:VERIZON EAP-#482
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-2704
Practice Address - Country:US
Practice Address - Phone:617-743-3965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1012821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical