| Shore Psychological Healthcare Llc | |
|
220 Jack Martin Boulvard Suite E2 Brick NJ 08724 | |
| (732) 920-3434 | |
| (732) 920-2447 |
| Full Name | Shore Psychological Healthcare Llc |
|---|---|
| Speciality | Psychologist |
| Location | 220 Jack Martin Boulvard, Brick, New Jersey |
| Authorized Official Name and Position | Kristine C. Keane (DIRECTOR) |
| Authorized Official Contact | 7329203434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shore Psychological Healthcare Llc 220 Jack Martin Boulvard Suite E2 Brick NJ 08724 Ph: (732) 920-3434 | Shore Psychological Healthcare Llc 220 Jack Martin Boulvard Suite E2 Brick NJ 08724 Ph: (732) 920-3434 |
| NPI Number | 1477563534 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 05/28/2022 |
| Certification Date | 05/28/2022 |
| Medicare PECOS PAC ID | 6305846379 |
|---|---|
| Medicare Enrollment ID | O20061226000015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477563534 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 4245 (New Jersey) | Primary |
| Provider Name | Kristine C Keane |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316945942 PECOS PAC ID: 2062435399 Enrollment ID: I20060112000336 |
| Provider Name | Abbie L Loughran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114216215 PECOS PAC ID: 1557650314 Enrollment ID: I20160517002538 |
| Provider Name | Kathleen Ann Boss |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992142673 PECOS PAC ID: 8527201169 Enrollment ID: I20181203003058 |
| Provider Name | Jessica Cavan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285993691 PECOS PAC ID: 9133458615 Enrollment ID: I20190909002269 |
| Provider Name | Alison S O Connor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366736233 PECOS PAC ID: 6709294531 Enrollment ID: I20210416000307 |
| Provider Name | Sarah R Fischbein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962071274 PECOS PAC ID: 6002219086 Enrollment ID: I20210728002600 |
| Provider Name | Gina Falcone |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881189074 PECOS PAC ID: 6305220641 Enrollment ID: I20220906000342 |
| Provider Name | Kristen Marcaly |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780815811 PECOS PAC ID: 9032585443 Enrollment ID: I20221026000247 |
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