Provider Demographics
NPI:1932131620
Name:SOKOLOWSKI, SHANNON R (LICSW)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:R
Last Name:SOKOLOWSKI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 183
Mailing Address - Street 2:
Mailing Address - City:SULLIVAN
Mailing Address - State:NH
Mailing Address - Zip Code:03445-0183
Mailing Address - Country:US
Mailing Address - Phone:774-260-1158
Mailing Address - Fax:508-433-1871
Practice Address - Street 1:439 COLUMBIA RD STE 205
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-2393
Practice Address - Country:US
Practice Address - Phone:774-260-1158
Practice Address - Fax:508-433-1871
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1122631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical