Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PS01757 | RI |
Y | 103G00000X | Clinical Psychologist | PS01757 | RI |
Y | 103TC0700X | Clinical Psychologist | PS01757 | RI |
NPI | 1316231913 |
---|---|
Provider Name | Dr. Shayna S Bassett |
First Address | Boston, MA 02114-2696 |
Second Address | Boston, MA 02114-2696 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2011 |
Last Update Date | 03/05/2021 |