Shyn A Childress

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2110 State St Ste 202
Salem, OR 97301-4350

Phone

(503) 580-9819

NPI assigned

Jun 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1205494069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4556 14TH CT S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022305",
            "telephone_number": "503-400-5744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 STATE ST STE 202",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014350",
            "telephone_number": "503-580-9819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1118 Oak St SE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973014019",
            "country_code": "US",
            "telephone_number": "503-400-5744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHILDRESS",
        "first_name": "SHYN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "22995",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122994",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Chicharro, NP
• Vitaly Chikrizov, MD
• Bryan Scott Child, MD
• Childhood Health Associates of Salem
• Children, Adults and Families - Child Welfare
• Denise Childs, LPC
• Wendy J Childs, L.AC.
• Albert Chira, PHARMD.
• Leon Chira, R.PH
• Olga Chira

• Mental Health Counselor in Salem, OR
• Providers in Salem, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; 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.