| South Shore Behavioral Health Clinic | |
|
200 Cordwainer Dr Suite 200 Norwell MA 02061-1671 | |
| (781) 878-8340 | |
| Not Available |
| Full Name | South Shore Behavioral Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 200 Cordwainer Dr, Norwell, Massachusetts |
| Authorized Official Name and Position | Kenneth Mj Rood (CLINICAL DIRECTOR) |
| Authorized Official Contact | 6179098019 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Shore Behavioral Health Clinic 200 Cordwainer Dr Suite 200 Norwell MA 02061-1671 Ph: (781) 878-8340 | South Shore Behavioral Health Clinic 200 Cordwainer Dr Suite 200 Norwell MA 02061-1671 Ph: (781) 878-8340 |
| NPI Number | 1720221740 |
|---|---|
| Provider Enumeration Date | 04/07/2009 |
| Last Update Date | 07/25/2018 |
| Medicare PECOS PAC ID | 5395881601 |
|---|---|
| Medicare Enrollment ID | O20130913000456 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720221740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Alfredo Chan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891746814 PECOS PAC ID: 6507760758 Enrollment ID: I20031120000530 |
| Provider Name | Mary E Barkalow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700864485 PECOS PAC ID: 2668415167 Enrollment ID: I20050606000915 |
| Provider Name | Deborah C Peckham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306982798 PECOS PAC ID: 1153336987 Enrollment ID: I20060215000049 |
| Provider Name | Cary P Gearhart |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326143934 PECOS PAC ID: 2466525647 Enrollment ID: I20080722000014 |
| Provider Name | Jennifer Gearhart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427117365 PECOS PAC ID: 3375844905 Enrollment ID: I20151223001163 |
| Provider Name | Carrie Lam Prendergast |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437513231 PECOS PAC ID: 2163715178 Enrollment ID: I20160728001878 |
| Provider Name | Patricia Kiessling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538385372 PECOS PAC ID: 5193089035 Enrollment ID: I20180501002091 |
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