| Shoreline Pastoral Counseling Llc | |
|
35 Boston St Guilford CT 06437-2817 | |
| (860) 301-6600 | |
| Not Available |
| Full Name | Shoreline Pastoral Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 35 Boston St, Guilford, Connecticut |
| Authorized Official Name and Position | Edward Cornell (PROVIDER) |
| Authorized Official Contact | 8603016600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shoreline Pastoral Counseling Llc 16 Sperry Rd Madison CT 06443-1737 Ph: (860) 301-6600 | Shoreline Pastoral Counseling Llc 35 Boston St Guilford CT 06437-2817 Ph: (860) 301-6600 |
| NPI Number | 1497401673 |
|---|---|
| Provider Enumeration Date | 02/25/2022 |
| Last Update Date | 02/25/2022 |
| Certification Date | 02/25/2022 |
| Medicare PECOS PAC ID | 5294179883 |
|---|---|
| Medicare Enrollment ID | O20240222002080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497401673 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Margaret H Cornell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043535636 PECOS PAC ID: 9931392537 Enrollment ID: I20101014001199 |
| Provider Name | Edward Cornell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154699155 PECOS PAC ID: 4880032994 Enrollment ID: I20240409003527 |
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