| North Shore Psychological Services, Pc | |
|
135 Main St Wenham MA 01984-1543 | |
| (978) 468-7671 | |
| (978) 468-9720 |
| Full Name | North Shore Psychological Services, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 135 Main St, Wenham, Massachusetts |
| Authorized Official Name and Position | Donald Deblock (PRESIDENT) |
| Authorized Official Contact | 9784687671 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Shore Psychological Services, Pc Po Box 567 Wenham MA 01984-2567 Ph: (978) 468-7671 | North Shore Psychological Services, Pc 135 Main St Wenham MA 01984-1543 Ph: (978) 468-7671 |
| NPI Number | 1306036348 |
|---|---|
| Provider Enumeration Date | 07/26/2007 |
| Last Update Date | 07/26/2007 |
| Medicare PECOS PAC ID | 9931280518 |
|---|---|
| Medicare Enrollment ID | O20080122000217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306036348 | NPI | - | NPPES |
| WO4426 | Other | MA | BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 4602 (Massachusetts) | Primary |
| Provider Name | Donald Deblock |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912094202 PECOS PAC ID: 6709977341 Enrollment ID: I20070810000264 |
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