Provider Demographics
NPI:1003798281
Name:SHANAHAN, MARTHA (LMHC)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:SHANAHAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 PLYMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:HALIFAX
Mailing Address - State:MA
Mailing Address - Zip Code:02338-1418
Mailing Address - Country:US
Mailing Address - Phone:781-413-5707
Mailing Address - Fax:781-413-5707
Practice Address - Street 1:141 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1779
Practice Address - Country:US
Practice Address - Phone:781-413-5707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11140101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health