Evening Shinerock

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW020505 Issued in PA

Practice address

701 S 50TH St FL 3
Philadelphia, PA 19143-1689

Phone

(347) 470-9084

NPI assigned

Aug 12, 2020

Sex

Female

Sole proprietor

No

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

Practice roles

Locations

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

• Green River Counseling LLC

  • Clinical Social Worker
  • Philadelphia, PA
  • NPI 1770358756
  NPD Authorized official

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1134730245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S 50TH ST FL 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S 50TH ST FL 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431689",
            "telephone_number": "347-470-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINEROCK",
        "first_name": "EVENING",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW020505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Shindler, MD
• Shine Healthcare Group LLC
• Shine Medical Providers PC
• Shine Speech Language Pathology, LLC
• Melissa Viola Shiner, PHARMD CGP BCPP MHA
• Aakash Tushar Shingala, MD
• Shining Gracefully Homecare LLC
• Shining Keys Royal Care Services LLC
• Brianna Shinn, MD
• Rebecca Ellen Shinn, BCBA

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.