A New Shore Counseling
Organization Active NPI Clinical Social Worker · Louisville, KY
NPI 1801487145 · NPPES record last updated Feb 18, 2021
Key facts
- NPI
- 1801487145
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- A NEW SHORE COUNSELING
- Practice address
- 4211 Poplar Level Rd Ste 103
Louisville, KY 40213-1527 - Phone
- (502) 694-0042
- Fax
- (502) 305-2123
- NPI assigned
- Jan 29, 2021
- Organization subpart
- No
Authorized official
- Name
- Sarah E Wilburn, LCSW
- Title
- Owner/Practitoner
- Phone
- (502) 694-0042
Practitioners 1
-
Sarah Elizabeth Wilburn, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210303002505 | KY | Part B Supplier - Clinic/Group Practice | 2769898444 |
Receives reassigned benefits from 1 practitioner Practice locations: Louisville, KY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | Yes |
Addresses
Primary practice location
4211 Poplar Level Rd Ste 103
Louisville, KY 40213-1527
Mailing address
4211 Poplar Level Rd Ste 103
Louisville, KY 40213-1527
Phone (502) 694-0042
Other names
- A New Shore Counseling, LLC
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2021. 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.