Mrs Jennifer Wyckoff Shore, LMHC - Counselor in Centerport, NY

Mrs Jennifer Wyckoff Shore, LMHC is a Counselor - Mental Health based in Centerport, New York. Mrs Jennifer Wyckoff Shore is licensed to practice in New York (license number 005020) and her current practice location is 31 Harbor Park Dr, Centerport, New York. She can be reached at her office (for appointments etc.) via phone at (631) 261-2692.

NPI number for Mrs Jennifer Wyckoff Shore is 1164794053 and her current mailing address is 31 Harbor Park Dr, Centerport, New York. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1164794053.

Contact Information

Mrs Jennifer Wyckoff Shore, LMHC
31 Harbor Park Dr,
Centerport, NY 11721-1623
(631) 261-2692
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameMrs Jennifer Wyckoff Shore
GenderFemale
SpecialityCounselor - Mental Health
Location31 Harbor Park Dr, Centerport, New York
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1164794053
  • Provider Enumeration Date: 02/07/2012
  • Last Update Date: 02/07/2012

Medical Identifiers

Medical identifiers for Mrs Jennifer Wyckoff Shore such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1164794053NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YM0800XCounselor - Mental Health 005020 (New York)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Jennifer Wyckoff Shore is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Jennifer Wyckoff Shore, LMHC
31 Harbor Park Dr,
Centerport, NY 11721-1623

Ph: (631) 261-2692
Mrs Jennifer Wyckoff Shore, LMHC
31 Harbor Park Dr,
Centerport, NY 11721-1623

Ph: (631) 261-2692

Reviews and Comments


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