Susan R Shore is a Clinical in Eastham, Massachusetts. Susan R Shore practices all healthcare services and medical treatments related to Clinical. The NPI Number for Susan R Shore is 1114084787. The last update date is 2015-10-07.
Susan R Shore's current location address is 130a Old Orchard Rd, Eastham, Massachusetts. You can contact this provider via phone number 5082559313 and fax number 5082559313. The mailing address for Susan R Shore is 130a Old Orchard Rd, Eastham, Massachusetts. To know further, please read the information below!
Provider Profile Detail
Provider Name | Susan R Shore |
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Address | 130a Old Orchard Rd, Eastham, Massachusetts |
Phone Number | 5082559313 |
Fax Number | 5082559313 |
Sole Proprietor | N |
Credentials | MSW LICSW |
NPI Number Detail
NPI Number | 1114084787 |
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Provider Enumeration Date | 2007-01-03 |
Last Updated Date | 2015-10-07 |
Provider Mailing Address Detail
Address | 130a Old Orchard Rd |
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City | Eastham |
State | Massachusetts (MA) |
Post Code | 26422102 |
Phone Number | 5082559313 |
Fax Number | 5082559313 |
Provider's Primary Taxonomy Detail
Speciality | Clinical |
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Taxonomy | 1041C0700X |
Licence No | MA111248 |
Definition: 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, certif |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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250971000 | MAGELLAN | ||
P07976 | BLUE CROSS HMO |
Post Comment/ Review Below
What is the unique identification code assigned to Susan R Shore by the Centers for Medicare & Medicaid Services?
The Susan R Shore has been issued the NPI (National Provider Identifier) 1114084787. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Susan R Shore's facilities are situated?
The facilities of Susan R Shore are physically located at the following address: 130A Old Orchard Rd, Eastham, MA, 26422102.
What is Susan R Shore's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Susan R Shore is Clinical, and the taxonomy code that categorizes this field of expertise is 1041C0700X.
On what date did Susan R Shore receive its 1114084787 assignment from the Centers for Medicare & Medicaid Services?
The Susan R Shore was assigned its 1114084787 on 2007-01-03, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Susan R Shore, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Susan R Shore, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2015-10-07.
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