Individual
MARK D SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
26 QUEEN ST, SOCIAL SERVICES, WORCESTER, MA 01610-2473
(508) 860-7700
(508) 860-7990
Mailing address
26 QUEEN ST, SOCIAL SERVICES, WORCESTER, MA 01610-2473
(508) 860-7700
(508) 860-7990
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
111762
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0300010
—
MA
01
—
1001250
GROUP
MA
05
—
1300709
—
MA
01
—
99622101
NETWORK HEALTH
MA
Enumeration date
08/09/2006
Last updated
07/09/2007
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