NPIMap

Organization Active NPI

Shore Psychological Healthcare LLC

  • Clinical Psychologist
  • Brick, NJ
National Provider Identifier
1477563534
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4245 Issued in 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
Last updated
Jan 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Authorized official

Name
Kristine C. Keane, PSY.D.NPI 1316945942
Title
Director
Phone
(732) 920-3434

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 4245 NJ Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory

Locations

220 Jack Martin Blvd
#E2
Brick, NJ 08724

220 Jack Martin Blvd
Ste E2
Brick, NJ 08724
Phone (732) 905-5600

1707 Atlantic Ave
Ste 4
Manasquan, NJ 08736

58 Maple Ave
Red Bank, NJ 07701

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1477563534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 JACK MARTIN BOULVARD",
            "address_2": "SUITE E2",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "08724",
            "telephone_number": "732-920-3434",
            "fax_number": "732-920-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 JACK MARTIN BOULVARD",
            "address_2": "SUITE E2",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "08724",
            "telephone_number": "732-920-3434",
            "fax_number": "732-920-2447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58 Maple Ave",
            "address_purpose": "LOCATION",
            "city": "Red Bank",
            "state": "NJ",
            "postal_code": "077011618",
            "country_code": "US",
            "telephone_number": "732-920-3434",
            "fax_number": "732-920-2447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1707 Atlantic Ave Ste 4",
            "address_purpose": "LOCATION",
            "city": "Manasquan",
            "state": "NJ",
            "postal_code": "087361147",
            "country_code": "US",
            "telephone_number": "732-920-3434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Iron Bridge Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Freehold",
            "state": "NJ",
            "postal_code": "077285305",
            "country_code": "US",
            "telephone_number": "732-920-3434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHORE PSYCHOLOGICAL HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "KEANE",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-920-3434",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "4245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.