SHINE FORTH LLC


Address: 6710 Willshire Blvd, Cheyenne, WY 82009-2757
Phone: 7192481789

SHINE FORTH LLC (NPI# 1528667201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1528667201
Entity Type Organization
Organization Name SHINE FORTH LLC
Practice Address 6710 Willshire Blvd
Cheyenne
WY 82009-2757
Practice Telephone 7192481789
Practice Fax Number 3075141080
Mailing Telephone 7192481789
Enumeration Date 2020-10-22
Last Update Date 2020-10-22
Authorized Official Name JUDIANN BRYANT (LPC/PROVIDER)
Authorized Official Telephone 7192481789
Authorized Official Credential LPC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional
Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
WY 153780600 05

Office Location

Street Address 6710 WILLSHIRE BLVD
City CHEYENNE
State WY
Zip Code 82009-2757

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1639443336 Jennifer Alam Case Manager/Care Coordinator 3304 E. I80 Service Rd, Cheyenne, WY 82009 2012-02-28
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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1356841597 Little Things Counseling Counselor 1603 Capitol Ave Ste 510a, Cheyenne, WY 82001-4563 2018-02-14
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1508314295 Jennifer Brooke Rigg Counselor 1226 Alyssa Way, Cheyenne, WY 82009-3867 2016-09-12
1629444351 Adam Elias Stuart-walker Counselor 1816 E 17th St, Cheyenne, WY 82001-5010 2015-08-17
1619227444 Foundations Counseling & Consulting of Wyoming, LLC Counselor 2003 Central Ave, Cheyenne, WY 82001-3745 2012-09-19
1952690836 Jamie Snyder Counselor 2000 Westland Rd Unit C, Cheyenne, WY 82001-3309 2011-03-31
1649575838 Debra A Williams Counselor 217 E 21st Street, Cheyenne, WY 82001-5356 2011-01-19
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Competitor

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City CHEYENNE
Zip Code 82009

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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