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MS. SUSAN R SHORE MSW LICSW BCD NPI 1114084787


NPI Information

NPI: 1114084787
Provider Name: MS. SUSAN R SHORE, MSW LICSW BCD
Classification: Social Worker - 1041C0700X
Entity Type: Individual

Specialization: Clinical

Address:
130A OLD ORCHARD RD
EASTHAM, MA
ZIP 02642
Phone: (508) 255-9313
Get Directions

MS. Susan R Shore, MSW LICSW BCD is a clinical social worker in Eastham, MA. The provider is 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, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. MS. Susan R Shore, MSW LICSW BCD NPI is 1114084787. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

130A OLD ORCHARD RD
EASTHAM, MA
ZIP 02642-102
Phone: (508) 255-9313
Fax: (508) 255-9313

The enumeration date for this NPI number is 1/3/2007 and was last updated on 10/7/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalMA111248MASSACHUSETTSYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1P07976OTHERBLUE CROSS HMO
2250971000OTHERMAGELLAN
3P22944MEDICARE ID-TYPE UNSPECIFIED

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: 4/28/2024

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