Provider Demographics
NPI:1982769634
Name:KNIGHTS, SHAHN ELIZABETH (LICSW)
Entity Type:Individual
Prefix:
First Name:SHAHN
Middle Name:ELIZABETH
Last Name:KNIGHTS
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 1:60 BICENTENIAL WAY
Mailing Address - Street 2:
Mailing Address - City:BOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:01719-2111
Mailing Address - Country:US
Mailing Address - Phone:978-635-9314
Mailing Address - Fax:978-635-9314
Practice Address - Street 1:4 STRAWBERRY HILL RD
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-5757
Practice Address - Country:US
Practice Address - Phone:978-264-2954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1111881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP07961OtherBCBS
MAP07961OtherBCBS