Mcneilly, Shannon

Mcneilly, Shannon is an individual health care provider with primary practice located at 176 Main St , Southbridge MA 01550-2561. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Mcneilly, Shannon can be contacted via phone (508) 765-5940.

Contact Information

Primary practice address
176 Main St Southbridge MA 01550-2561
Phone: (508) 765-5940
Fax: (508) 753-5051
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1558704916
LBN Legal business name Mcneilly, Shannon
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2013
Last updated Apr 16th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558704916 NPPES
Massachusetts MEDICAID 1308785
Massachusetts Other M18684
Massachusetts MEDICAID 1306421
Massachusetts Other 22220002001

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