Sara Shine

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1125 Centre St
St Italian Home
Jamaica Plain, MA 02130-3445

Phone

(617) 787-1901

Fax

(617) 254-3461

NPI assigned

Jul 12, 2007

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

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Group practices

Quincy Asian Resources IncGroup PAC ID 6406205137, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Quincy Asian Resources Inc

  • Mental Health Counselor
  • Quincy, MA
  • NPI 1144923160
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1144429028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77B WARREN ST",
            "address_2": "BAMHA",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "02135",
            "telephone_number": "617-787-1901",
            "fax_number": "617-254-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 CENTRE ST",
            "address_2": "ST ITALIAN HOME",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303445",
            "telephone_number": "617-787-1901",
            "fax_number": "617-254-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINE",
        "first_name": "SARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shayegani
• Matthew Edward Sheehan
• Beth Sherman, M.A
• Kenneth Lyle Sherman, LICSW
• Hyun Joon Shin, MD,SCD,MS,MPH
• Rachel Shor
• Shore Pine Psychiatry, PLLC
• Irina Shumway
• Elizabeth Sian, LMT
• Lydia C Siegel, MD, MPH

• Mental Health Counselor in Jamaica Plain, MA
• Providers in Jamaica Plain, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.