NPIMap

Organization Active NPI

Shore Resolutions LLC

  • Community/Behavioral Health Agency
  • Cambridge, MD
National Provider Identifier
1982906186
Registry record updated Dec 1, 2010
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Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
14584 Issued in MD
Legal business name
SHORE RESOLUTIONS LLC
Practice address
211 High St.
Cambridge, MD 21613-1816
Phone
(410) 228-4357
NPI assigned
Nov 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2010

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

Authorized official

Name
Lisa Ann Brenner, LCSW-C
Title
Owner/ Therapist
Phone
(410) 228-4357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 14584 MD Primary

Addresses

Primary practice location

211 High St.
Cambridge, MD 21613-1816

Mailing address

211 High St.
Cambridge, MD 21613-1816
Phone (410) 228-4357

Other identifiers 1

IdentifierTypeStateIssuer
033870200MedicaidMD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291161600000",
    "number": "1982906186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 HIGH ST.",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216131816",
            "telephone_number": "410-228-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 HIGH ST.",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216131816",
            "telephone_number": "410-228-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE RESOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-22",
        "last_updated": "2010-12-01",
        "status": "A",
        "authorized_official_last_name": "BRENNER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/ THERAPIST",
        "authorized_official_telephone_number": "410-228-4357",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "14584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033870200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.