Individual provider Active NPI

Shannon Teresa Franch, LICSW

  • Social Worker
  • Brockton, MA
National Provider Identifier
1124516596
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
113081 Issued in MA
Practice address
110 Mulberry St
Brockton, MA 02302-2066
Phone
(508) 894-3733
Fax
(508) 559-7695
NPI assigned
May 1, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 113081 MA Primary

Addresses

Primary practice location

110 Mulberry St
Brockton, MA 02302-2066

Mailing address

110 Mulberry St
Brockton, MA 02302-2066
Phone (508) 894-3733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
113081MAMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1124516596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MULBERRY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022066",
            "telephone_number": "508-894-3733",
            "fax_number": "508-559-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MULBERRY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022066",
            "telephone_number": "508-894-3733",
            "fax_number": "508-559-7695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANCH",
        "first_name": "SHANNON",
        "middle_name": "TERESA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "113081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.