| Shore Behavioral Services | |
|
1613 Rte 88 West Suite6 Brick NJ 08724 | |
| (732) 938-3080 | |
| (732) 938-3085 |
| Full Name | Shore Behavioral Services |
|---|---|
| Speciality | Counselor |
| Location | 1613 Rte 88 West Suite6, Brick, New Jersey |
| Authorized Official Name and Position | Thomas Walter Chemris (PRESIDENT) |
| Authorized Official Contact | 7329383080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shore Behavioral Services Po Box 361 Allenwood NJ 08720-0361 Ph: (732) 938-3080 | Shore Behavioral Services 1613 Rte 88 West Suite6 Brick NJ 08724 Ph: (732) 938-3080 |
| NPI Number | 1043304876 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 07/29/2008 |
| Medicare PECOS PAC ID | 7810938263 |
|---|---|
| Medicare Enrollment ID | O20050517000320 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043304876 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 44SC05184500 (New Jersey) | Primary |
| Provider Name | Thomas W Chemris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710944798 PECOS PAC ID: 5799747333 Enrollment ID: I20041029000091 |
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