Provider Demographics
NPI:1407634132
Name:NORTH SHORE COUNSELING SOLUTIONS
Entity Type:Organization
Organization Name:NORTH SHORE COUNSELING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CLINICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:TAI
Authorized Official - Middle Name:
Authorized Official - Last Name:PRYJMA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:617-645-3393
Mailing Address - Street 1:8 NAPLES RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAMILTON
Mailing Address - State:MA
Mailing Address - Zip Code:01982-1604
Mailing Address - Country:US
Mailing Address - Phone:617-645-3393
Mailing Address - Fax:
Practice Address - Street 1:8 NAPLES RD
Practice Address - Street 2:
Practice Address - City:SOUTH HAMILTON
Practice Address - State:MA
Practice Address - Zip Code:01982-1604
Practice Address - Country:US
Practice Address - Phone:617-645-3393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-14
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty