Provider Demographics
NPI:1497837256
Name:SOUTH SHORE CENTER FOR GUIDANCE & COUNSELING
Entity Type:Organization
Organization Name:SOUTH SHORE CENTER FOR GUIDANCE & COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:EVANGELINE
Authorized Official - Last Name:DENNEHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-828-8666
Mailing Address - Street 1:1030 TURNPIKE ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2827
Mailing Address - Country:US
Mailing Address - Phone:781-828-8666
Mailing Address - Fax:781-575-1795
Practice Address - Street 1:1030 TURNPIKE ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2827
Practice Address - Country:US
Practice Address - Phone:781-828-8666
Practice Address - Fax:781-575-1795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA709192OtherTUFTS
MA42722OtherMAGELLAN
MAM13859OtherBCBS
MA709192OtherTUFTS
MA=========OtherPACIFICARE
MA=========OtherVALUE OPTIONS
MA=========OtherTEAMSTERS
MAM13859OtherBCBS
MAM13859OtherBCBS