| Shore Integrated Counseling Llc | |
|
1010 State Route 71 Ste 2a Spring Lake NJ 07762-3223 | |
| (732) 763-0719 | |
| Not Available |
| Full Name | Shore Integrated Counseling Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1010 State Route 71 Ste 2a, Spring Lake, New Jersey |
| Authorized Official Name and Position | Balesterri Carrie (OWNER) |
| Authorized Official Contact | 7327630719 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shore Integrated Counseling Llc 1341 Bennett Ln Manasquan NJ 08736-1149 Ph: () - | Shore Integrated Counseling Llc 1010 State Route 71 Ste 2a Spring Lake NJ 07762-3223 Ph: (732) 763-0719 |
| NPI Number | 1487266839 |
|---|---|
| Provider Enumeration Date | 08/18/2020 |
| Last Update Date | 09/30/2020 |
| Certification Date | 09/30/2020 |
| Medicare PECOS PAC ID | 9032529904 |
|---|---|
| Medicare Enrollment ID | O20201104000569 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487266839 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Dena Baldassarre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124552393 PECOS PAC ID: 1658648738 Enrollment ID: I20170519001657 |
| Provider Name | Maria N Cowan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609380120 PECOS PAC ID: 7719228378 Enrollment ID: I20190408002204 |
| Provider Name | Carrie L Balesterri |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497053813 PECOS PAC ID: 9931434289 Enrollment ID: I20190710000322 |
| Provider Name | Dena Agolio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538694823 PECOS PAC ID: 9335510643 Enrollment ID: I20230125000767 |
| Provider Name | Kelsey Marie Blakeslee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992457980 PECOS PAC ID: 9537502257 Enrollment ID: I20240209002599 |
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