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: July 19, 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
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

Accepted Insurance

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Psychologist
504 DUDLEY ST
ROXBURY, MA 02119
Counselor
504 DUDLEY ST
ROXBURY, MA 02119
Social Worker
504 DUDLEY ST
ROXBURY, MA 02119
Counselor (Mental Health)
504 DUDLEY ST
ROXBURY, MA 02119
Counselor (Mental Health)
504 DUDLEY ST
ROXBURY, MA 02119
Social Worker
504 DUDLEY ST
ROXBURY, MA 02119
Counselor
504 DUDLEY ST
BOSTON, MA 02119
Counselor (Mental Health)
504 DUDLEY ST
ROXBURY, MA 02119
Counselor (Mental Health)
504 DUDLEY ST
ROXBURY, MA 02119
Counselor
504 DUDLEY ST
ROXBURY, MA 02119
Counselor
504 DUDLEY ST
ROXBURY, MA 02119
Counselor
504 DUDLEY ST
ROXBURY, MA 02119
Counselor (Mental Health)
504 DUDLEY ST
ROXBURY, MA 02119
Counselor
504 DUDLEY ST
ROXBURY, MA 02119
Counselor
504 DUDLEY ST
ROXBURY, MA 02119
Counselor (Mental Health)
504 DUDLEY ST
ROXBURY, MA 02119
Counselor
504 DUDLEY ST
ROXBURY, MA 02119
Counselor (Mental Health)
504 DUDLEY ST
ROXBURY, MA 02119
Counselor (Mental Health)
504 DUDLEY ST
ROXBURY, MA 02119
Counselor
504 DUDLEY ST
ROXBURY, MA 02119

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1821767922, enumerated as an "individual" on September 10, 2021.

The provider is located at 504 DUDLEY ST ROXBURY, MA 02119 and the phone number is (617) 445-6655.

Social Worker with taxonomy code 1041C0700X and a focus in Clinical.

The provider might be accepting Accepts: Harvard Pilgrim Health Care and Providence Health. Please consult your insurance carrier or call the provider to verify.