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SHINE INTEGRATIVE THERAPY LLC NPI 1578080412


NPI Information

NPI: 1578080412
Provider Name: SHINE INTEGRATIVE THERAPY, LLC
Classification: Marriage & Family Therapist - 106H00000X
Entity Type: Organization
Address:
1103 N MAIN ST
NEWTON, KS
ZIP 67114
Phone: (316) 803-1011
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SHINE INTEGRATIVE THERAPY, LLC is a marriage family therapist in Newton, KS. The provider is a marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. SHINE INTEGRATIVE THERAPY, LLC NPI is 1578080412. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1103 N MAIN ST
NEWTON, KS
ZIP 67114-837
Phone: (316) 803-1011
Fax: (316) 803-1754

The provider's authorized official is Tracy Smith .
The authorized official title is Owner and has the following contact phone number (316) 803-1011.

The enumeration date for this NPI number is 8/22/2017 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1106H00000XMarriage & Family Therapist2885KANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1201168070MEDICAIDKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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