Provider Demographics
NPI:1932512738
Name:SHIELDS, ANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:SHIELDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ROB RIDER RD
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CT
Mailing Address - Zip Code:06896-1303
Mailing Address - Country:US
Mailing Address - Phone:203-938-4965
Mailing Address - Fax:
Practice Address - Street 1:2 ROB RIDER RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CT
Practice Address - Zip Code:06896-1303
Practice Address - Country:US
Practice Address - Phone:203-241-8170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT40151041C0700X
NY730290621041C0700X
CTC0320120018971041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool