Provider Demographics
NPI:1316798994
Name:CASEY, SHANNON ELIZABETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:ELIZABETH
Last Name:CASEY
Suffix:
Gender:F
Credentials:PSYD
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Mailing Address - Street 1:161 WASHINGTON ST APT 1111
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3516
Mailing Address - Country:US
Mailing Address - Phone:703-725-1797
Mailing Address - Fax:
Practice Address - Street 1:77 WARREN ST BLDG 2
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3601
Practice Address - Country:US
Practice Address - Phone:617-383-7804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist