Provider Demographics
NPI:1346608817
Name:SHORE HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:SHORE HEALTH AND WELLNESS LLC
Other - Org Name:SUSAN M. CATTERMOLE LCSW
Other - Org Type:Other Name
Authorized Official - Title/Position:PSYCHOTHERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CATTERMOLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-546-2339
Mailing Address - Street 1:2105 APPLEBY DR
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4633
Mailing Address - Country:US
Mailing Address - Phone:732-546-2339
Mailing Address - Fax:732-361-6633
Practice Address - Street 1:621 SHREWSBURY AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4153
Practice Address - Country:US
Practice Address - Phone:732-546-2339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051950001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty