| Shine Therapy Pllc | |
|
1444 Michigan St Ne Ste 7 Grand Rapids MI 49503-2028 | |
| (616) 259-4548 | |
| Not Available |
| Full Name | Shine Therapy Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1444 Michigan St Ne Ste 7, Grand Rapids, Michigan |
| Authorized Official Name and Position | Cathy Gallegos (MANGER) |
| Authorized Official Contact | 5174832461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shine Therapy Pllc 1711 Carlton Ave Ne Grand Rapids MI 49505-5439 Ph: (231) 590-3297 | Shine Therapy Pllc 1444 Michigan St Ne Ste 7 Grand Rapids MI 49503-2028 Ph: (616) 259-4548 |
| NPI Number | 1720668148 |
|---|---|
| Provider Enumeration Date | 04/09/2021 |
| Last Update Date | 04/09/2021 |
| Certification Date | 04/09/2021 |
| Medicare PECOS PAC ID | 6305255266 |
|---|---|
| Medicare Enrollment ID | O20210505000335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720668148 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Rachel M Mcclure |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306288477 PECOS PAC ID: 0042517211 Enrollment ID: I20160404000095 |
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