Provider Demographics
NPI:1053575761
Name:KRAAI, SHANNA R (MSW)
Entity type:Individual
Prefix:
First Name:SHANNA
Middle Name:R
Last Name:KRAAI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:SHANNA
Other - Middle Name:R
Other - Last Name:VAN ZYL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:530 GREAT RD STE 2
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3443
Mailing Address - Country:US
Mailing Address - Phone:978-225-3252
Mailing Address - Fax:
Practice Address - Street 1:530 GREAT RD STE 2
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3443
Practice Address - Country:US
Practice Address - Phone:978-225-3252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 104100000X
MA1251161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker