Provider Demographics
NPI:1639254782
Name:HART, SHELLEY (MA)
Entity type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:
Last Name:HART
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 SHERIFFS LN
Mailing Address - Street 2:
Mailing Address - City:EAST SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02537-1365
Mailing Address - Country:US
Mailing Address - Phone:508-737-1598
Mailing Address - Fax:
Practice Address - Street 1:20 TREMONT ST STE 29
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-5315
Practice Address - Country:US
Practice Address - Phone:774-454-8896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health