Shaine Talia Malekgoodar, LPC-MSHP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3368 Issued in TN

Practice address

131 Indian Lake Rd Ste 102
Hendersonville, TN 37075-3884

Phone

(615) 474-9012

NPI assigned

Nov 11, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1013218726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 INDIAN LAKE RD STE 102",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370753884",
            "telephone_number": "615-474-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 INDIAN LAKE RD STE 102",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370753884",
            "telephone_number": "615-474-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALEKGOODAR",
        "first_name": "SHAINE",
        "middle_name": "TALIA",
        "credential": "LPC-MSHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-11",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "3368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Radcliff Magoun, M.D.
• Sara Danette Magoun, MSN, APN, FNP-C
• McClain Elise Maiolo, FNP
• Viktoriia Makarova
• Jeremiah Maldonado
• Mackenize Malin
• John Hal Malone III, MS.
• Margaret Wing-Yan Mann, MD
• Gina T Mansfield, NP
• Dana Lynn Marchetti, FNP

• Professional Counselor in Hendersonville, TN
• Providers in Hendersonville, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.