Individual provider Active NPI

Shanda M McLain

  • Mental Health Counselor
  • Grand Island, NE
National Provider Identifier
1255720116
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10406 Issued in NE
Practice address
312 N Elm St
Grand Island, NE 68801-4509
Phone
(308) 384-2520
Fax
(308) 382-7600
NPI assigned
Jan 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10406 NE Primary

Addresses

Primary practice location

312 N Elm St
Grand Island, NE 68801-4509

Mailing address

312 N Elm St
Grand Island, NE 68801-4509
Phone (308) 384-2520

Other identifiers 1

IdentifierTypeStateIssuer
10026370500MedicaidNE

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

LicenseStateTypeSpecialty
10406NEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1255720116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 N ELM ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688014509",
            "telephone_number": "308-384-2520",
            "fax_number": "308-382-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 N ELM ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688014509",
            "telephone_number": "308-384-2520",
            "fax_number": "308-382-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAIN",
        "first_name": "SHANDA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "10406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026370500",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; 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.