| Shore Path Counseling Llc | |
|
9 Sherwin Dr Enfield CT 06082-2065 | |
| (860) 558-5514 | |
| Not Available |
| Full Name | Shore Path Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 9 Sherwin Dr, Enfield, Connecticut |
| Authorized Official Name and Position | Jaime Bohan (MANAGER) |
| Authorized Official Contact | 8605585514 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shore Path Counseling Llc Po Box 277 Enfield CT 06083-0277 Ph: (860) 558-5514 | Shore Path Counseling Llc 9 Sherwin Dr Enfield CT 06082-2065 Ph: (860) 558-5514 |
| NPI Number | 1023866415 |
|---|---|
| Provider Enumeration Date | 05/09/2024 |
| Last Update Date | 05/17/2024 |
| Certification Date | 05/17/2024 |
| Medicare PECOS PAC ID | 6103363981 |
|---|---|
| Medicare Enrollment ID | O20240730003004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023866415 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Jaime Bohan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922855089 PECOS PAC ID: 9638616295 Enrollment ID: I20240806001370 |
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