Shore Therapy Center for Wellness, LLC

NPI #1063067866 in Wilmette, Illinois

Provider Information

NPI Number: 1063067866
Entity Type: Organization
Organization Name: Shore Therapy Center for Wellness, LLC
Primary Specialty: Psychologist - Clinical
Enumeration Date: Aug 8, 2019
Last Updated: Aug 8, 2019

Practice Location

Address: 3330 OLD GLENVIEW RD STE 16
City: Wilmette
State: Illinois
ZIP Code: 60091-2963
Phone: (630) 362-0129

Authorized Official

Name: DR. CORRIE A GOLDBERG, PHD
Title: LICENSED CLINICAL PSYCHOLOGIST
Phone: (630) 362-0129

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Cognitive & Behavioral — Cognitive & Behavioral	103TB0200X
Psychologist - Clinical Child & Adolescent — Clinical Child & Adolescent	103TC2200X
Psychologist - Clinical — Clinical	103TC0700X	Primary

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