Provider Demographics
NPI:1639592058
Name:BROWN, SHENAY
Entity Type:Individual
Prefix:
First Name:SHENAY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 MIDDLESEX AVE # 1012
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-1105
Mailing Address - Country:US
Mailing Address - Phone:617-380-3173
Mailing Address - Fax:
Practice Address - Street 1:74 PLAINFIELD AVE
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-4510
Practice Address - Country:US
Practice Address - Phone:857-234-2049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-22
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker