Shantay Mines, ED.S, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFTA #9001A Issued in NC

Practice address

160 E Virginia St Ste 100
San Jose, CA 95112-5865

Phone

(408) 287-6200

NPI assigned

May 23, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mr. Shawn Mines Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: shantaymines@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Marriage & Family Therapist

  NPD

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1083051544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 EPIC WAY APT 123",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951342836",
            "telephone_number": "862-204-9364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E VIRGINIA ST STE 100",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951125865",
            "telephone_number": "408-287-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5139 Deer Park Drive",
            "address_purpose": "LOCATION",
            "city": "New Port Richey",
            "state": "FL",
            "postal_code": "34653",
            "country_code": "US",
            "telephone_number": "813-999-5928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINES",
        "first_name": "SHANTAY",
        "name_prefix": "Mr.",
        "credential": "ED.S, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-23",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "124011",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "IMT2104",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "LMFTA #9001A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://gardnerhealthservices.org/",
            "affiliation": "N",
            "address_1": "160 E Virginia St Ste 100",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951125865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHAWN",
            "last_name": "MINES",
            "prefix": "MR.",
            "credential": "MA, ED.S, LMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mindy H Pelz Chiropractic Corporation
• Ashley Lauren Mine, PA-C
• Gabrielle Minehan, CCP
• Monica Mineo, PHARMD
• Anthony Eliot Miner, PSY.D.
• Maria Minetti
• Ming-Jer Chou DDS Inc
• Alyson Mingrone
• Minh Nhat Le OD, Inc. (EyeQ Optometry)
• Minh Tran Chiropractic, PC

• Marriage & Family Therapist in San Jose, CA
• Providers in San Jose, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.