MS. SUSAN R SHORE MSW LICSW BCD
NPI 1114084787
Social Worker - Clinical in Eastham, MA

Active since January 03, 2007
130A OLD ORCHARD RD, EASTHAM, MA 02642(508) 255-9313(508) 255-9313 Get Directions Write a Review

NPPES record last updated: October 7, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ms. Susan R Shore Msw Licsw Bcd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. SUSAN R SHORE MSW LICSW BCD (NPI 1114084787) is an individual clinical provider in Eastham, Massachusetts, licensed in Massachusetts (MA111248) and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1114084787
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMS. SUSAN R SHORECredential: MSW LICSW BCD
Location Address130A OLD ORCHARD RDEastham, MA 02642-2102
Mailing Address130a Old Orchard RdEastham, MA 02642-2102 · (508) 255-9313 · Fax (508) 255-9313
Fax(508) 255-9313
Sole ProprietorNo
Enumeration DateJanuary 3, 2007
Last NPPES UpdateOctober 7, 2015
NPI 1114084787 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in MA · MA111248
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
130A OLD ORCHARD RD, Eastham, MA 02642

Other Identifiers 3

OtherP07976Blue Cross Hmo
Other250971000Magellan
Medicare ID-Type UnspecifiedP22944

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Susan Shore's NPI number?

The NPI number for Susan Shore is 1114084787. It was assigned to this individual provider in the NPPES registry on January 3, 2007.

Where is Susan Shore located?

Susan Shore practices at 130A Old Orchard Rd, Eastham, MA 02642. The listed phone number is (508) 255-9313.

What is Susan Shore's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Susan Shore was last updated on October 7, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.