Shore, Susan R
Shore, Susan R is an individual health care provider with primary practice located at 130A Old Orchard Rd , Eastham MA 02642-2102. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Shore, Susan R can be contacted via phone (508) 255-9313.Contact Information
Primary practice address
130A Old Orchard Rd
Eastham MA 02642-2102
Phone: (508) 255-9313
Fax: (508) 255-9313
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | MA111248 | Massachusetts |
Profile Details
| NPI number | 1114084787 |
|---|---|
| LBN Legal business name | Shore, Susan R |
| Credentials | MSW LICSW BCD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 3rd, 2007 |
| Last updated | Oct 7th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114084787 | NPPES |
| Other | 250971000 | MAGELLAN | |
| Other | P07976 | MAGELLAN |
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