| A New Shore Counseling, Llc | |
|
4211 Poplar Level Rd Ste 103 Louisville KY 40213-1527 | |
| (502) 694-0042 | |
| (502) 305-2123 |
| Full Name | A New Shore Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4211 Poplar Level Rd Ste 103, Louisville, Kentucky |
| Authorized Official Name and Position | Sarah E Wilburn (OWNER/PRACTITONER) |
| Authorized Official Contact | 5026940042 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A New Shore Counseling, Llc 4211 Poplar Level Rd Ste 103 Louisville KY 40213-1527 Ph: (502) 694-0042 | A New Shore Counseling, Llc 4211 Poplar Level Rd Ste 103 Louisville KY 40213-1527 Ph: (502) 694-0042 |
| NPI Number | 1801487145 |
|---|---|
| Provider Enumeration Date | 01/29/2021 |
| Last Update Date | 02/18/2021 |
| Certification Date | 02/18/2021 |
| Medicare PECOS PAC ID | 2769898444 |
|---|---|
| Medicare Enrollment ID | O20210303002505 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801487145 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sarah Elizabeth Wilburn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275932162 PECOS PAC ID: 1254600943 Enrollment ID: I20170714001055 |
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