| Shoreline Psychotherapy | |
|
35 Atlantic Ave Manasquan NJ 08736-2901 | |
| (631) 241-8054 | |
| Not Available |
| Full Name | Shoreline Psychotherapy |
|---|---|
| Speciality | Social Worker |
| Location | 35 Atlantic Ave, Manasquan, New Jersey |
| Authorized Official Name and Position | Jessica Cavan (SOLE MEMBER) |
| Authorized Official Contact | 6312418054 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shoreline Psychotherapy 175 W Cohawkin Rd Ste C Clarksboro NJ 08020-1145 Ph: (856) 423-7700 | Shoreline Psychotherapy 35 Atlantic Ave Manasquan NJ 08736-2901 Ph: (631) 241-8054 |
| NPI Number | 1902529399 |
|---|---|
| Provider Enumeration Date | 09/21/2022 |
| Last Update Date | 05/15/2023 |
| Certification Date | 05/15/2023 |
| Medicare PECOS PAC ID | 7315304961 |
|---|---|
| Medicare Enrollment ID | O20230613001890 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902529399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jessica Cavan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285993691 PECOS PAC ID: 9133458615 Enrollment ID: I20190909002269 |
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