Shannon J Hendrickson, PMHCNS, BC
Counselor in Medford, Massachusetts
1073649919- Practice location
- 151 Mystic Ave, Medford, MA 02155-4632
- Phone
- 781-396-1199
- Fax
- 781-396-1439
- Last updated
- October 5, 2009
Shannon Jane Hendrickson is a Counselor based in Medford, MA. Shannon Jane Hendrickson practices in Medford, MA and has the professional credentials of PMHCNS, BC. The NPI Number for Shannon Jane Hendrickson is 1073649919 and holds a License No. 110897 (MA). The current practice location address for Shannon Jane Hendrickson is 151 Mystic Ave, Medford, MA 02155-4632 and can be reached out via phone at 781-396-1199 and via fax at 781-396-1439.
Provider Profile Details
- NPI Number
- 1073649919
- Provider Name
- Shannon Jane Hendrickson
- Credential
- PMHCNS, BC
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 151 Mystic Ave, Medford, MA 02155-4632
- Phone Number
- 781-396-1199
- Fax Number
- 781-396-1439
- Primary Taxonomy
- Counselor · 101Y00000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- February 26, 2007
- Last Update Date
- October 5, 2009
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 151 Mystic Ave
Medford, MA 02155-4632 - City
- Medford
- State
- Massachusetts
- Zip
- 02155-4632
- Phone Number
- 781-396-1199
- Fax Number
- 781-396-1439
Provider Business Mailing Address Details
- Address
- 151 Mystic Ave
Medford, MA 02155-4632 - City
- Medford
- State
- MA
- Zip
- 02155-4632
- Phone Number
- 781-396-1199
- Fax Number
- 781-396-1439
License Information
- License Number
- 110897
- License State
- MA
- Taxonomy
- Counselor · 101Y00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Counselors near Medford, MA
View all Counselors in Medford →Frequently Asked Questions
What is the NPI number of Shannon J Hendrickson, PMHCNS, BC?
The NPI number of Shannon J Hendrickson, PMHCNS, BC is 1073649919. It was assigned on February 26, 2007 and is currently active in the NPPES registry.
What is the specialty of Shannon J Hendrickson, PMHCNS, BC?
Shannon J Hendrickson, PMHCNS, BC is registered under the primary taxonomy Counselor (code 101Y00000X), licensed in MA under license number 110897.
Where does Shannon J Hendrickson, PMHCNS, BC practice?
The practice location is 151 Mystic Ave, Medford, MA 02155-4632. The office can be reached at 781-396-1199 (phone) or 781-396-1439 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1073649919 directly on the NPPES registry website.