Shore Psychological Healthcare LLC
Organization Active NPI Clinical Psychologist · Brick, NJ
NPI 1477563534 · NPPES record last updated Jan 28, 2026
Key facts
- NPI
- 1477563534
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 4245 (NJ)
- Legal business name
- SHORE PSYCHOLOGICAL HEALTHCARE LLC
- Practice address
- 220 Jack Martin Boulvard
Suite E2
Brick, NJ 08724 - Phone
- (732) 920-3434
- Fax
- (732) 920-2447
- NPI assigned
- Aug 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Kristine C. Keane, PSY.D.
- Title
- Director
- Phone
- (732) 920-3434
Practitioners 28
-
Gina N Falcone, PHD
-
B. Michelle Foster, MA, LAC, ED.D
-
Kristine Cangelosi Keane, PSY.D.
-
Carlie M Manto, LPC
-
Alison Stothard O'Connor, PSYD, BCBA
-
Nicole Claire Peniston, PSYD
-
Jordan Policari, LCSW
-
Kelsey Elizabeth Wetmore, LPC, LCADC
-
Crystal Lee Williams, LAC
-
Abbie Lynn Loughran, LMSW
-
Brenna Sadowski, LCSW, CCTP, LCADC
-
Anna Cain, PH.D.
-
Edward Vincent Macnish Jr., L.P.C.
-
Jessica Casey, LPC
-
Melissa Jackson, LAC
-
Crystal Elena Delia, LPC, LCADC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061226000015 | NJ | Part B Supplier - Clinic/Group Practice | 6305846379 |
Receives reassigned benefits from 17 practitioners Practice locations: Brick, NJ; Neptune, NJ; Red Bank, NJ |
National Provider Directory
Locations
220 Jack Martin Blvd
Ste E2
Brick, NJ 08724
Phone (732) 905-5600
220 Jack Martin Blvd
#E2
Brick, NJ 08724
1707 Atlantic Ave
Ste 4
Manasquan, NJ 08736
58 Maple Ave
Red Bank, NJ 07701
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | 4245 | NJ | Yes |
Addresses
Primary practice location
220 Jack Martin Boulvard
Suite E2
Brick, NJ 08724
Mailing address
220 Jack Martin Boulvard
Suite E2
Brick, NJ 08724
Phone (732) 920-3434
Other practice location 1
58 Maple Ave
Red Bank, NJ 07701-1618
Phone (732) 920-3434
Other practice location 2
1707 Atlantic Ave Ste 4
Manasquan, NJ 08736-1147
Phone (732) 920-3434
Other practice location 3
501 Iron Bridge Rd Ste 4
Freehold, NJ 07728-5305
Phone (732) 920-3434
Other providers in Brick, NJ
- Shore Family Practice LLC
- Shore Home Physical Therapy LLC
- Shore House Calls
- Shore Points Oral Surgery & Implant Center LLC
- Shore Psychiatric Associates LLC
- Shore Radiation Oncology, LLC.
- Shore Rehabilitation Institute
- Shore Renal Care
- Shore Solutions Therapy Group
- Shorrock Gardens Care Center Inc.
All providers in Brick, NJ · Clinical Psychologist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2026. 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.