SHORESIDE THERAPIES NPI 1134334063

NPI Information

NPI: 1134334063
Provider Name: SHORESIDE THERAPIES
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
4530 N OAKLAND AVE
MILWAUKEE, WI
ZIP 53211
Phone: (414) 332-7000
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SHORESIDE THERAPIES is a mental health counselor in Milwaukee, WI. SHORESIDE THERAPIES NPI is 1134334063. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4530 N OAKLAND AVE
MILWAUKEE, WI
ZIP 53211-215
Phone: (414) 332-7000
Fax: (414) 332-2368

The provider's authorized official is Nancy Shertok .
The authorized official title is Psychotherapist and has the following contact phone number (414) 332-7000.

The enumeration date for this NPI number is 5/14/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	2844-125	WISCONSIN	Yes
2	1041C0700X	Social Worker	Clinical	2138-123	WISCONSIN	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2524	OTHER	WISCONSIN	CERT MH OUTPATIENT CLINIC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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