Shore Therapy Center for Wellness, PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SHORE THERAPY CENTER FOR WELLNESS, PLLC

Practice address

1189 Wilmette Ave # 174
Wilmette, IL 60091-2719

Phone

(847) 558-1546

Fax

(847) 787-1868

NPI assigned

Jan 18, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Corrie A. Goldberg, PH.D.NPI 1821553934

Title

Owner

Phone

(847) 558-1546

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Corrie Adina Goldberg, PH.D.

  • Clinical Psychologist
  • Wilmette, IL
  • NPI 1821553934
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642464000000",
    "number": "1285385617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 MARION AVE",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355130",
            "telephone_number": "630-362-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1189 WILMETTE AVE # 174",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912719",
            "telephone_number": "847-558-1546",
            "fax_number": "847-787-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE THERAPY CENTER FOR WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "CORRIE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-558-1546",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aveen Sharma
• Judith Mary Shaw, L.C.S.W.
• Emma Shellenback, DPT
• Amy Shinohara, DT
• Shore Therapy Center for Wellness, LLC
• Gail Joyce Shorr, M.D.
• Ashley Shrum
• Shvartsman Eyecare PC
• Richard E. Simon, LCPC
• Susan R. Singerman, M.A.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Wilmette, IL
• Providers in Wilmette, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.