| Shine Counseling, Pllc | |
|
1931 J N Pease Pl Ste 104 Charlotte NC 28262-4540 | |
| (704) 734-9480 | |
| (844) 786-5796 |
| Full Name | Shine Counseling, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1931 J N Pease Pl Ste 104, Charlotte, North Carolina |
| Authorized Official Name and Position | Kimberly Parker (OWNER) |
| Authorized Official Contact | 7045481328 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shine Counseling, Pllc 1931 J N Pease Pl Ste 104 Charlotte NC 28262-4540 Ph: (704) 548-1328 | Shine Counseling, Pllc 1931 J N Pease Pl Ste 104 Charlotte NC 28262-4540 Ph: (704) 734-9480 |
| NPI Number | 1871066019 |
|---|---|
| Provider Enumeration Date | 01/10/2019 |
| Last Update Date | 08/20/2023 |
| Certification Date | 08/20/2023 |
| Medicare PECOS PAC ID | 5799017349 |
|---|---|
| Medicare Enrollment ID | O20191030003707 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871066019 | NPI | - | NPPES |
| 1041C0700X | Medicaid | NC |
| Provider Name | Valerie Chess |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255493847 PECOS PAC ID: 4183715907 Enrollment ID: I20120907000352 |
| Provider Name | Kimberly M Parker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922502061 PECOS PAC ID: 4082967666 Enrollment ID: I20181029001916 |
| Provider Name | Alicia Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760704274 PECOS PAC ID: 5799026498 Enrollment ID: I20190405002180 |
| Provider Name | Laura Dunston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871195289 PECOS PAC ID: 5294192696 Enrollment ID: I20230530002754 |
| Provider Name | Tierra J Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689169641 PECOS PAC ID: 2466703426 Enrollment ID: I20231121003865 |
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