Provider Demographics
NPI:1548390438
Name:MCSHEFFREY, CAROL ANN (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:MCSHEFFREY
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1507
Mailing Address - Country:US
Mailing Address - Phone:508-254-4862
Mailing Address - Fax:
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:WAC - 023
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-724-5301
Practice Address - Fax:617-726-7676
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2023-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10157081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO5292Medicare ID - Type UnspecifiedINSURANCE NUMBER