Provider Demographics
NPI:1689460230
Name:SHREMSHOCK, GENE MARIE
Entity type:Individual
Prefix:
First Name:GENE MARIE
Middle Name:
Last Name:SHREMSHOCK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 CLUB VILLA COURT
Mailing Address - Street 2:GENEMARIESHREMSHOCK@GMAIL.COM
Mailing Address - City:KATHLEEN
Mailing Address - State:GA
Mailing Address - Zip Code:31014-3101
Mailing Address - Country:US
Mailing Address - Phone:478-449-1475
Mailing Address - Fax:877-712-4794
Practice Address - Street 1:304 FRANKLIN SQ
Practice Address - Street 2:
Practice Address - City:BONAIRE
Practice Address - State:GA
Practice Address - Zip Code:31005-3256
Practice Address - Country:US
Practice Address - Phone:478-449-1475
Practice Address - Fax:877-712-4794
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW011980104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker