Selby Shields Bourne, MSW, LICSW
Social Worker, Clinical in Centerville, MA. Individual provider (NPI-1).
NPI number1609196237
StatusActive
Last updated in NPPESMar 27, 2024
Details
- NPI
- 1609196237
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Selby Shields Bourne
- Credential
- MSW, LICSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 5, 2010
- Certification date
- Mar 25, 2024
- Last updated
- Mar 27, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 119067 | MA | Yes |
Practice location
889 W Main StSuite C.
Centerville, MA 02632-3067
Phone 508-771-2402
Mailing address
Coastal Wellness, LLC105 Webster St. Suite 5
Hanover, MA 02339
Phone 508-360-2811
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All 18 Clinical Social Worker providers in Centerville · All 161 providers in Centerville
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