Individual
SHANNON KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
150 S HUNTINGTON AVE, SOCIAL WORK SERVICES (122), BOSTON, MA 02130
(774) 826-3570
Mailing address
150 S HUNTINGTON AVE, SOCIAL WORK SERVICES (122), BOSTON, MA 02130
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
125829
MA
104100000X
Social Worker
225686
MA
1041C0700X
Clinical Social Worker
125829
MA
Other
Enumeration date
07/27/2018
Last updated
01/18/2024
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