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MISS SHANNON ALYSE RANDOLPH MSW, LICSW
NPI 1821767922
Social Worker - Clinical in Roxbury, MA

Active since September 10, 2021
504 DUDLEY ST, ROXBURY, MA 02119(617) 445-6655 Get Directions Write a Review

NPPES record last updated: May 6, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 6, 2025, Sep 10, 2021 (2 updates tracked since 2021).

About Miss Shannon Alyse Randolph Msw, Licsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS SHANNON ALYSE RANDOLPH MSW, LICSW (NPI 1821767922) is an individual clinical provider in Roxbury, Massachusetts, licensed in Massachusetts (LICSW1121000) and active in the NPI registry since September 2021.

NPPES Registry Identity

NPI1821767922
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMISS SHANNON ALYSE RANDOLPHCredential: MSW, LICSW
Location Address504 DUDLEY STRoxbury, MA 02119-2732
Mailing Address1 Bmc Place, Moakley Connector Office 1301Boston, MA 02118 · (617) 638-7147
Phone(617) 445-6655
Sole ProprietorYes
Enumeration DateSeptember 10, 2021
Last NPPES UpdateMay 6, 20252 updates tracked since enumeration
NPPES CertifiedApril 23, 2025
✔ NPI 1821767922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MA · LICSW1121000
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
504 DUDLEY ST, Roxbury, MA 02119
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Harvard Pilgrim Health Care, Providence Health Plan.Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMMA SULLIVAN
Counselor (Mental Health)
504 DUDLEY ST
ROXBURY, MA 02119
Suffolk County (617) 445-6655
PHARA JEAN DENIS
Counselor (Mental Health)
504 DUDLEY ST
ROXBURY, MA 02119
Suffolk County (617) 445-6655
DOMINIQUE RENEE STEWART
Counselor
504 DUDLEY ST
ROXBURY, MA 02119
Suffolk County (617) 445-6655
BLANCA PUMAREJO
Counselor
504 DUDLEY ST
ROXBURY, MA 02119
Suffolk County (617) 955-2427
XINYUAN LI
Counselor
504 DUDLEY ST
ROXBURY, MA 02119
Suffolk County (617) 445-6655
LUIS RAFAEL CRUZ
Counselor
504 DUDLEY ST
ROXBURY, MA 02119
Suffolk County (786) 348-4412
ANTOINETTE WEBSTER
Counselor
504 DUDLEY ST
ROXBURY, MA 02119
Suffolk County (617) 445-6655
TE'SHAWN NICOLE CONLEY
Counselor (Mental Health)
504 DUDLEY ST
ROXBURY, MA 02119
Suffolk County (857) 919-7922

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Randolph's NPI number?

The NPI number for Shannon Randolph is 1821767922. It was assigned to this individual provider in the NPPES registry on September 10, 2021.

Where is Shannon Randolph located?

Shannon Randolph practices at 504 Dudley St, Roxbury, MA 02119. The listed phone number is (617) 445-6655.

What is Shannon Randolph's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

What insurance does Shannon Randolph accept?

Health plans from Harvard Pilgrim Health Care and Providence Health Plan list Shannon Randolph as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shannon Randolph was last updated on May 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.