Provider Demographics
NPI:1124811351
Name:XU, SHENGMEI (M ED)
Entity type:Individual
Prefix:
First Name:SHENGMEI
Middle Name:
Last Name:XU
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 BEACONSFIELD RD UNIT 113
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-3302
Mailing Address - Country:US
Mailing Address - Phone:217-778-6991
Mailing Address - Fax:
Practice Address - Street 1:1 BROOKLINE PL STE 321
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7237
Practice Address - Country:US
Practice Address - Phone:617-405-5735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA101YM0800XMedicaid