Provider Demographics
NPI:1831322833
Name:SHUTE, ASHLEY BROOKE (MSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BROOKE
Last Name:SHUTE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:BROOKE
Other - Last Name:LEAVITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:118 LONG POND RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2662
Mailing Address - Country:US
Mailing Address - Phone:508-747-8833
Mailing Address - Fax:508-747-8835
Practice Address - Street 1:118 LONG POND RD
Practice Address - Street 2:SUITE 102
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2662
Practice Address - Country:US
Practice Address - Phone:508-747-8833
Practice Address - Fax:508-747-8835
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216236104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker