Provider Demographics
NPI:1407426331
Name:HERDMAN, SHAYLIN MARIE (LICSW)
Entity type:Individual
Prefix:
First Name:SHAYLIN
Middle Name:MARIE
Last Name:HERDMAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:698 SOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:WHITMAN
Mailing Address - State:MA
Mailing Address - Zip Code:02382-2214
Mailing Address - Country:US
Mailing Address - Phone:617-699-5844
Mailing Address - Fax:
Practice Address - Street 1:169 LIBBEY PKWY
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3189
Practice Address - Country:US
Practice Address - Phone:508-238-7766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041S0200X
MALICSW11215741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool