Michael R Shanahan, M.DIV/LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1379 Issued in MA

Practice address

1354 Hancock St Ste 209
Quincy, MA 02169-5109

Phone

(617) 471-5686

Fax

(617) 471-5686

NPI assigned

Nov 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 2, 2024 through Apr 2, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Maria Droste Counseling Services, Inc.

  • Mental Health Counselor
  • Quincy, MA
  • NPI 1467018333
  NPD Authorized official

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1962483313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1354 HANCOCK ST STE 209",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021695109",
            "telephone_number": "617-471-5686",
            "fax_number": "617-471-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1354 HANCOCK ST STE 209",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021695109",
            "telephone_number": "617-471-5686",
            "fax_number": "617-471-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "M.DIV/LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1279",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MA",
            "license": "1379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "601120738",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "407950700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "820S5SH",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "70010000LF0190",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "171987",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cameron Shahbazian, DMD
• Shahrzad Shahbazian, DMD
• Alyson Louise Shaheen, M.S., CCC-SLP
• Jessica Shakr
• Shammah Healthcare Services, LLC
• Nalaya Shand, LCSW
• Jessica Shannon
• Rui Shao
• Jessica Shaw, RD
• Lashaun Shaw

• Marriage & Family Therapist in Quincy, MA
• Providers in Quincy, MA by specialty
• Marriage & Family Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.