Healthcare Provider Details

I. General information

NPI: 1912296823
Provider Name (Legal Business Name): SOUTH SHORE PSYCHOLOGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2011
Last Update Date: 03/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 SUMMER ST SUITE 2B
HINGHAM MA
02043-2246
US

IV. Provider business mailing address

3 SUMMER ST SUITE 2B
HINGHAM MA
02043-2246
US

V. Phone/Fax

Practice location:
  • Phone: 781-749-3606
  • Fax:
Mailing address:
  • Phone: 781-749-3606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number9298
License Number StateMA

VIII. Authorized Official

Name: DR. JENNIFER HILLS EPSTEIN
Title or Position: LICENSED PSYCHOLOGIST, MANAGER
Credential: PSY.D.
Phone: 781-749-3606