Organization
SOUTH SHORE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOROTHY A YEAMEN MPA (COO)
(401) 364-7705
Entity
Organization
Contact information
Practice address
4705A OLD POST RD, CHARLESTOWN, RI 02813-1819
(401) 364-7705
(401) 364-9104
Mailing address
PO BOX 899, CHARLESTOWN, RI 02813-0899
(401) 364-7705
(401) 364-9104
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201774
BLUE CHIP GROUP ID
RI
01
—
25450
BLUE CROSS GROUP ID
RI
05
—
9001875
—
RI
05
—
SS02237
—
RI
Enumeration date
09/23/2005
Last updated
01/24/2013
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