Shaw, Lisa

Shaw, Lisa is an sole proprietor health care provider with primary practice located at 344 Harvard St Suite #1, Brookline MA 02446-2917. She recently has 8 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / Health Service, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is her primary health care specialty. Shaw, Lisa can be contacted via phone (617) 277-6286.

Contact Information

Primary practice address
344 Harvard St Suite #1 Brookline MA 02446-2917
Phone: (617) 277-6286
Fax: (617) 277-6286
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 3659 Massachusetts
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 3659 Massachusetts
Behavioral Health & Social Service Providers / Clinical 103TC0700X 3659 Massachusetts
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 3659 Massachusetts
Behavioral Health & Social Service Providers / Family 103TF0000X 3659 Massachusetts
Behavioral Health & Social Service Providers / Health Service 103TH0100X 3659 Massachusetts
Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities 103TM1800X 3659 Massachusetts
Behavioral Health & Social Service Providers / Psychologist 103T00000X 3659 Massachusetts

Profile Details

NPI number 1982740627
LBN Legal business name Shaw, Lisa
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 29th, 2007
Last updated Jul 9th, 2007 - about 17 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 1982740627 NPPES
Massachusetts MEDICAID 0514489
Massachusetts Other W03688

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