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Organization
ELLEN SHAW-SMITH LICSW BCN, LLC
Active
Organization
ELLEN SHAW-SMITH LICSW BCN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELLEN MICHELLE SHAW-SMITH LICSW BCN (SOLO CLINICAL SOCIAL WORKER)
(413) 582-0355
Entity
Organization
Contact information
Practice address
104 RUSSELL ST, HADLEY, MA 01035-9570
(413) 582-0355
(413) 582-0411
Mailing address
PO BOX 622, HADLEY, MA 01035-0622
(413) 582-0355
(413) 582-0411
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
113030
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110081474A
—
MA
Enumeration date
12/13/2017
Last updated
12/13/2017
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