Individual
DR. LISA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
344 HARVARD ST, SUITE #1, BROOKLINE, MA 02446-2917
(617) 277-6286
(617) 277-6286
Mailing address
56 MARSHAL ST # 3, BROOKLINE, MA 02446-5423
(617) 277-6286
(617) 277-6286
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
3659
MA
103T00000X
Psychologist
3659
MA
103TB0200X
Cognitive & Behavioral Psychologist
3659
MA
103TC0700X
Clinical Psychologist
3659
MA
103TC2200X
Clinical Child & Adolescent Psychologist
3659
MA
103TF0000X
Family Psychologist
3659
MA
103TH0100X
Health Service Psychologist
3659
MA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
3659
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0514489
—
MA
01
—
W03688
BCBSMA PROVIDER NUMBER
MA
Enumeration date
01/29/2007
Last updated
09/11/2025
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