Healthcare Provider Details

I. General information

NPI: 1114643947
Provider Name (Legal Business Name): SHORELINE COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 DODGE ST UNIT C NORTH BEVERLY PLAZA #1019
BEVERLY MA
01915
US

IV. Provider business mailing address

65 DODGE ST UNIT C NORTH BEVERLY PLAZA #1019
BEVERLY MA
01915
US

V. Phone/Fax

Practice location:
  • Phone: 978-473-2252
  • Fax:
Mailing address:
  • Phone: 978-473-2252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARAH FINNIE
Title or Position: MENTAL HEALTH COUNSELOR
Credential: LICSW
Phone: 978-473-2252