Provider Demographics
NPI:1831471747
Name:HEBERT, SHANNA (LCSW, LICSW)
Entity type:Individual
Prefix:
First Name:SHANNA
Middle Name:
Last Name:HEBERT
Suffix:
Gender:F
Credentials:LCSW, LICSW
Other - Prefix:
Other - First Name:SHANNA
Other - Middle Name:
Other - Last Name:MCNAMARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-5310
Mailing Address - Country:US
Mailing Address - Phone:413-200-2366
Mailing Address - Fax:
Practice Address - Street 1:264 N MAIN ST STE 10
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-1837
Practice Address - Country:US
Practice Address - Phone:860-461-7792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker