MISS Shannon Alyse Randolph, MSW, LICSW
NPI #1821767922 in Roxbury, Massachusetts
Provider Information
- NPI Number
- 1821767922
- Entity Type
- Individual
- Name
- MISS Shannon Alyse Randolph, MSW, LICSW
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Social Worker - Clinical
- Credential
- MSW, LICSW
- Enumeration Date
- Sep 10, 2021
- Last Updated
- May 6, 2025
Practice Location
- Address
- 504 DUDLEY ST
- City
- Roxbury
- State
- Massachusetts
- ZIP Code
- 02119-2732
- Phone
- (617) 445-6655
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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