MEDICARE: NORTH SHORE COUNSELING CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor
3	103T00000X	Psychologist
4	103TB0200X	Cognitive & Behavioral Psychologist
5	103TC0700X	Clinical Psychologist
6	103TC1900X	Counseling Psychologist
7	103TC2200X	Clinical Child & Adolescent Psychologist
8	103TF0000X	Family Psychologist
9	103TM1800X	Intellectual & Developmental Disabilities Psychologist
10	104100000X	Social Worker
11	1041C0700X	Clinical Social Worker
12	251S00000X	Community/Behavioral Health Agency	MA
13	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
14	101Y00000X	Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	W10026	OTHER	MA	BLUE CROSS
2	1010630	OTHER	MA	BEACON HEALTH
3	901877	OTHER	MA	TUFTS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	M12435	OTHER	MA	BLUE CROSS
6	97964101	OTHER	MA	NETWORK HEALTH

General Provider Information

NPI Number	:	1023187366
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH SHORE COUNSELING CENTER INC

Provider Business Mailing Address
First Line	:	100 CUMMINGS CTR STE 307E
Second Line	:
City	:	BEVERLY
State	:	MA
Zip	:	01915-6107
Country	:	US
Telephone Number	:	978-922-2280
Fax Number	:	978-927-1758

Provider Business Practice Location Address
First Line	:	100 CUMMINGS CTR STE 307E
Second Line	:
City	:	BEVERLY
State	:	MA
Zip	:	01915-6107
Country	:	US
Telephone Number	:	978-922-2280
Fax Number	:	978-927-1758

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JEFFREY D CILCUS
Credential	:
Telephone Number	:	978-922-2280

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	04/29/2025

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