Healthcare Provider Details

I. General information

NPI: 1174487235
Provider Name (Legal Business Name): NORTH SHORE PSYCHIATRY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 PATRIOT LN UNIT 11
GEORGETOWN MA
01833-2238
US

IV. Provider business mailing address

2 PATRIOT LN UNIT 11
GEORGETOWN MA
01833-2238
US

V. Phone/Fax

Practice location:
  • Phone: 617-906-8916
  • Fax:
Mailing address:
  • Phone: 617-906-8916
  • Fax: 857-219-6006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. MADELEINE LEPORE
Title or Position: OWNER
Credential: NP
Phone: 617-906-8916