Individual provider Active NPI

Shanya G Gilmore, MS

  • Mental Health Counselor
  • West Palm Beach, FL
National Provider Identifier
1174877351
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH18497 Issued in FL
Practice address
2640 Forest Hill Blvd
West Palm Beach, FL 33406-5931
Phone
(561) 616-8411
NPI assigned
Nov 9, 2012
Last updated
Mar 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH18497 FL Primary
Social Worker 104100000X NU

Addresses

Primary practice location

2640 Forest Hill Blvd
West Palm Beach, FL 33406-5931

Mailing address

2640 Forest Hill Blvd
West Palm Beach, FL 33406-5931
Phone (561) 616-8411

Other practice location 1

2051 Martin Luther King Jr Blvd
101
Riviera Beach, FL 33404-7004
Phone (561) 683-4778

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
IMH18497FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Preservation Services Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1174877351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 FOREST HILL BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334065931",
            "telephone_number": "561-616-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 FOREST HILL BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334065931",
            "telephone_number": "561-616-8411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2051 Martin Luther King Jr Blvd",
            "address_2": "101",
            "address_purpose": "LOCATION",
            "city": "Riviera Beach",
            "state": "FL",
            "postal_code": "334047004",
            "country_code": "US",
            "telephone_number": "561-683-4778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "SHANYA",
        "middle_name": "G",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-09",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH18497",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.