Provider Demographics
NPI:1598824922
Name:MCSHANE, MANUELA PAOLA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:MANUELA
Middle Name:PAOLA
Last Name:MCSHANE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 STATLER RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-4167
Mailing Address - Country:US
Mailing Address - Phone:617-489-4378
Mailing Address - Fax:617-489-9524
Practice Address - Street 1:68 LEONARD ST
Practice Address - Street 2:SUITE 306
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-2522
Practice Address - Country:US
Practice Address - Phone:617-538-8132
Practice Address - Fax:617-489-9524
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5836101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health