Provider Demographics
NPI:1902664592
Name:ALKINS, SHERANN KAMILAH NOLLEY (LICSW)
Entity type:Individual
Prefix:
First Name:SHERANN
Middle Name:KAMILAH NOLLEY
Last Name:ALKINS
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 1:47 GOODALE RD # 3
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02126-1527
Mailing Address - Country:US
Mailing Address - Phone:413-222-6138
Mailing Address - Fax:
Practice Address - Street 1:47 GOODALE RD # 3
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02126-1527
Practice Address - Country:US
Practice Address - Phone:413-222-6138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA419440101YS0200X
MA3425411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty