Active NPI
Judith Primm-Shimahara, MFT, LADC
- Marriage & Family Therapist
- Reno, NV
National Provider Identifier
1144362013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 0685
- Practice address
- 85 Kirman Ave
Reno, NV 89502 - Phone
- (775) 982-2862
- Fax
- (775) 982-2865
- NPI assigned
- Feb 13, 2007
- Last updated
- Oct 26, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 689L | NV | |
| Marriage & Family Therapist | 106H00000X | 0685 | NV | Primary |
Addresses
Primary practice location
85 Kirman Ave
Reno, NV 89502
Mailing address
850 Harvard Way
Reno, NV 89502-2055
Phone (775) 982-5262
Other practice location 1
1155 Mill St.
Code K8
Reno, NV 89502-1474
Phone (775) 982-5320
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0685 | Other | NV | MFT |
| 0689-L | Other | NV | LADC |
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 |
|---|---|---|---|
| 689L | NV | MD | Addiction (Substance Use Disorder) Counselor |
| 0685 | NV | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540512000000",
"number": "1144362013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 HARVARD WAY",
"city": "RENO",
"state": "NV",
"postal_code": "895022055",
"telephone_number": "775-982-5262",
"fax_number": "775-982-5496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 KIRMAN AVE",
"city": "RENO",
"state": "NV",
"postal_code": "89502",
"telephone_number": "775-982-2862",
"fax_number": "775-982-2865"
}
],
"practiceLocations": [
{
"address_1": "1155 Mill St.",
"address_2": "Code K8",
"address_purpose": "LOCATION",
"city": "Reno",
"state": "NV",
"postal_code": "895021474",
"country_code": "US",
"telephone_number": "775-982-5320",
"fax_number": "775-982-5690",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PRIMM-SHIMAHARA",
"first_name": "JUDITH",
"name_prefix": "Ms.",
"credential": "MFT, LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2018-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NV",
"license": "689L",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NV",
"license": "0685",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MFT",
"identifier": "0685",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LADC",
"identifier": "0689-L",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
- Prime Healthcare Services Reno LLC (Reno Cyberknife)
- Prime Healthcare Services Reno LLC
- Prime Healthcare Services Reno LLC (Saint Mary's Medical Equipment Provider)
- Prime Healthcare Services Reno LLC
- Prime Healthcare Solutions, LLC (Sierra Nevada Home Health)
- Theresa Albertine Prina-Tonner, M.S.,CCC-SLP
- Amanda Jewell Prina, M.S.W., L.S.W.
- Myrissa Margaret Prince, OTR/L
- Laura Prinz
- Priority One Lifestyle Management
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.