Shore Counseling, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SHORE COUNSELING, LLC

Practice address

100 Helfen Bein LN Ste 230a
Chester, MD 21619-2667

Phone

(410) 622-3202

NPI assigned

Jul 11, 2019

Organization subpart

No

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

Authorized official

Name

Ms. Kathleen Traversari, LCSW-CNPI 1760921241

Title

Director

Phone

(410) 622-3202

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shore Counseling, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 2

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

• Kathleen Traversari

  • Clinical Social Worker
  • Chester, MD
  • NPI 1760921241
  Medicare reassignment Care Compare group NPD Authorized official
• Carina Wilt, LCSW-C

  • Clinical Social Worker
  • Easton, MD
  • NPI 1922754019
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562803200000",
    "number": "1831741610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HELFEN BEIN LN STE 230A",
            "city": "CHESTER",
            "state": "MD",
            "postal_code": "216192667",
            "telephone_number": "410-622-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HELFEN BEIN LN STE 230A",
            "city": "CHESTER",
            "state": "MD",
            "postal_code": "216192667",
            "telephone_number": "410-622-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-11",
        "last_updated": "2019-07-11",
        "status": "A",
        "authorized_official_last_name": "TRAVERSARI",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "410-622-3202",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "986689",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shore Counseling, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Aisha Sadaf, DMD
• Noella Buwah Sama
• Peter Mytthias Schirmer IV
• Don J Schmitt, MSW, LCSW-C
• Sheel Kiritkumar Shah, PHARMD
• Courtney Sitar, CRNP
• Sonoscan LLC
• Gary J Sprouse, M.D.
• Sarah Stauffer
• Daniel Aaron Stockton, OTR/L

• Mental Health Counselor in Chester, MD
• Providers in Chester, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; 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.