Individual provider · Type 1 NPI

Shannon Alyse Randolph, MSW, LICSW

Clinical Social Worker · Roxbury, MA

NPI number 1821767922 Active

Practice location

504 Dudley St
Roxbury, MA 02119-2732

Call (617) 445-6655 Map

Mailing address

1 Bmc Place, Moakley Connector Office 1301
Boston, MA 02118

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XLICSW1121000 (MA)

Clinical Social Worker: 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 interpers…

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About NPI 1821767922

Shannon Alyse Randolph, MSW, LICSW's National Provider Identifier is 1821767922, issued on Sep 10, 2021. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Roxbury, MA. The record was last updated on May 6, 2025.