Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shayna Provencher, LCSW

Individual provider Clinical Social Worker · NPI 1801593199

Shayna Provencher, LCSW is a Clinical Social Worker in New London, Connecticut. Qualified in 2021, 5 years ago. Practices as a sole proprietor. Licensed in Connecticut.

Years since qualifying
5
Licensed in
CT
In the registry since
2023
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

164 Hempstead St
New London, CT 06320-5638
Phone: (860) 237-3273
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 13552 (CT)

Record details

NPI number1801593199
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedFebruary 8, 2023
Last updated in NPPESJanuary 6, 2025
Certification dateJanuary 6, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated

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