Organization
SHORELINE NEUROPSYCHIATRIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE JAMIE STEVENS PMHNP (OWNER)
(203) 693-1510
Entity
Organization
Contact information
Practice address
99 WHITFIELD ST, GUILFORD, CT 06437-3429
(203) 244-3443
(860) 261-0669
Mailing address
6209 KNIGHTSGATE CT, CHARLOTTE, NC 28269-0603
(203) 693-1510
(938) 253-3590
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
12.004567
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
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Other
Enumeration date
03/09/2017
Last updated
01/13/2025
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