| Shore Neurocognitive Health Llc | |
|
7656 Woodland Dr Easton MD 21601-8140 | |
| (410) 443-1039 | |
| Not Available |
| Full Name | Shore Neurocognitive Health Llc |
|---|---|
| Speciality | Social Worker |
| Location | 7656 Woodland Dr, Easton, Maryland |
| Authorized Official Name and Position | Elizabeth Jane Parker-o'brien (OWNER) |
| Authorized Official Contact | 4104431039 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shore Neurocognitive Health Llc 7656 Woodland Dr Easton MD 21601-8140 Ph: (410) 443-1039 | Shore Neurocognitive Health Llc 7656 Woodland Dr Easton MD 21601-8140 Ph: (410) 443-1039 |
| NPI Number | 1972043750 |
|---|---|
| Provider Enumeration Date | 02/28/2017 |
| Last Update Date | 02/28/2017 |
| Medicare PECOS PAC ID | 0749566214 |
|---|---|
| Medicare Enrollment ID | O20170418000235 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972043750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 13193 (Maryland) | Primary |
| Provider Name | Elizabeth J Parker O'brien |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679558910 PECOS PAC ID: 2264457688 Enrollment ID: I20070124000625 |
| Provider Name | Yvonne M Liswell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396878005 PECOS PAC ID: 4284777863 Enrollment ID: I20100204000257 |
| Provider Name | Maggie B Black |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285912550 PECOS PAC ID: 5092985242 Enrollment ID: I20110826000457 |
| Provider Name | Jenny L Jarrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750455747 PECOS PAC ID: 5698949477 Enrollment ID: I20111111000523 |
| Provider Name | Amanda E Andrew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811596182 PECOS PAC ID: 4284046988 Enrollment ID: I20201223000063 |
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