Provider Demographics
NPI:1083290936
Name:NORTH SHORE ASSESSMENT, INC.
Entity Type:Organization
Organization Name:NORTH SHORE ASSESSMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:978-233-1322
Mailing Address - Street 1:152 REAR MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WENHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01944
Mailing Address - Country:US
Mailing Address - Phone:978-233-1322
Mailing Address - Fax:978-560-1234
Practice Address - Street 1:152 REAR MAIN STREET
Practice Address - Street 2:
Practice Address - City:WENHAM
Practice Address - State:MA
Practice Address - Zip Code:01944
Practice Address - Country:US
Practice Address - Phone:978-233-1322
Practice Address - Fax:978-560-1234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1336398619OtherNPI