Provider Demographics
NPI:1831487727
Name:STUART-SHOR, JESSICA PAIGE (PMHNP, RN, LMHC)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:PAIGE
Last Name:STUART-SHOR
Suffix:
Gender:F
Credentials:PMHNP, RN, LMHC
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:PAIGE
Other - Last Name:WESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:36 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-4557
Mailing Address - Country:US
Mailing Address - Phone:617-726-2947
Mailing Address - Fax:
Practice Address - Street 1:200 SPRINGS RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1114
Practice Address - Country:US
Practice Address - Phone:781-681-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2390992163WP0808X, 363LP0808X
NC8627101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional