| Organization Name: | NORTH SHORE PSYCHOLOGICAL SERVICES, PC |
| NPI Number: | 1306036348 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONALD DEBLOCK (PRESIDENT) |
| Mailing Address: | 135 Main St Wenham |
| State: | MA US |
| Postal Code: | 019841543 |
| Phone Number: | 9784687671 |
| Fax Number: | 9784689720 |
| NPI Enumeration Date: | 07/26/2007 |
| NPI Last Update Date: | 07/26/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 4602 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |