North Shore Psychological Services, PC
Organization Active NPI Clinical Psychologist · Wenham, MA
NPI 1306036348 · NPPES record last updated Jul 26, 2007
Key facts
- NPI
- 1306036348
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 4602 (MA)
- Legal business name
- NORTH SHORE PSYCHOLOGICAL SERVICES, PC
- Practice address
- 135 Main St
Wenham, MA 01984-1543 - Phone
- (978) 468-7671
- Fax
- (978) 468-9720
- NPI assigned
- Jul 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Donald Deblock, PH.D.
- Title
- President
- Phone
- (978) 468-7671
Practitioners 1
-
Donald Deblock, PH.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080122000217 | MA | Part B Supplier - Clinic/Group Practice | 9931280518 |
Receives reassigned benefits from 1 practitioner Practice locations: Wenham, MA |
National Provider Directory
Locations
176 Bay Rd
South Hamilton, MA 01982
Phone (508) 468-7671
135 Main St
Wenham, MA 01984
Phone (978) 468-7671
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | 4602 | MA | Yes |
Addresses
Primary practice location
135 Main St
Wenham, MA 01984-1543
Mailing address
PO Box 567
Wenham, MA 01984-2567
Phone (978) 468-7671
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WO4426 | Other | MA | BC/BS |
Other providers in Wenham, MA
- Francine Molay
- Ariana Desiree Moran
- John Gerard Mulvihill
- Rachel Nelson
- North Shore Assessment, Inc.
- Patrick Pang
- Julie A Patterson
- Leigh Perreault
- Stacy Pineda
- Alyson Preston
All providers in Wenham, MA · Clinical Psychologist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.