| North Shore Counseling Center Inc | |
|
23 Broadway Beverly MA 01915-4417 | |
| (978) 922-2280 | |
| (978) 927-1758 |
| Full Name | North Shore Counseling Center Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 23 Broadway, Beverly, Massachusetts |
| Authorized Official Name and Position | Samuel Mark Migdole (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9789222280 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Shore Counseling Center Inc 23 Broadway Beverly MA 01915-4417 Ph: (978) 922-2280 | North Shore Counseling Center Inc 23 Broadway Beverly MA 01915-4417 Ph: (978) 922-2280 |
| NPI Number | 1023187366 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8628138153 |
|---|---|
| Medicare Enrollment ID | O20081113000562 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023187366 | NPI | - | NPPES |
| 1010630 | Other | MA | BEACON HEALTH |
| 97964101 | Other | MA | NETWORK HEALTH |
| M12435 | Other | MA | BLUE CROSS |
| W10026 | Other | MA | BLUE CROSS |
| 901877 | Other | MA | TUFTS |
| 1302892 | Medicaid | MA |
| Provider Name | Nechal Tejwani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962565135 PECOS PAC ID: 3577547629 Enrollment ID: I20040616000200 |
| Provider Name | Karen Vautour |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881748069 PECOS PAC ID: 7911957501 Enrollment ID: I20050201000286 |
| Provider Name | Wendy P Ohara |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306866710 PECOS PAC ID: 3476595679 Enrollment ID: I20050527000286 |
| Provider Name | Mercy Mugure Bashir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558673616 PECOS PAC ID: 8820250509 Enrollment ID: I20131216000743 |
| Provider Name | Nyssa York Green |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265683494 PECOS PAC ID: 8527495670 Enrollment ID: I20200302000719 |
| Provider Name | Lauren S Carpenter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689117624 PECOS PAC ID: 1153750518 Enrollment ID: I20200406002016 |
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