Active NPI
Harold Shines Jr., LSW
- Social Worker
- Evansville, IN
National Provider Identifier
1053821702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 99081998A
- Practice address
- 3231 N Green River Rd
Evansville, IN 47715-1379 - Phone
- (812) 479-1856
- NPI assigned
- Oct 9, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 99081998A | IN | Primary |
Addresses
Primary practice location
3231 N Green River Rd
Evansville, IN 47715-1379
Mailing address
826 Oak St
Franklin, KY 42134-1059
Phone (812) 725-1997
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 99081998A | IN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507507200000",
"number": "1053821702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "826 OAK ST",
"city": "FRANKLIN",
"state": "KY",
"postal_code": "421341059",
"telephone_number": "812-725-1997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3231 N GREEN RIVER RD",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477151379",
"telephone_number": "812-479-1856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHINES",
"first_name": "HAROLD",
"name_suffix": "Jr.",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-10-09",
"last_updated": "2017-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IN",
"license": "99081998A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.