Provider Demographics
NPI:1245720960
Name:SH SQUARED CARES
Entity type:Organization
Organization Name:SH SQUARED CARES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STACY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:805-369-2239
Mailing Address - Street 1:212 S MAIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-9350
Mailing Address - Country:US
Mailing Address - Phone:058-369-2239
Mailing Address - Fax:
Practice Address - Street 1:212 S MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-9350
Practice Address - Country:US
Practice Address - Phone:058-369-2239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-17
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP25805235Z00000X
CAPSY28777103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty