Shining Light Skill Building LLC

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

Legal business name

SHINING LIGHT SKILL BUILDING LLC

Practice address

3055 Old Highway 8 Ste 106B
St. Anthony, MN 55418

Phone

(612) 978-0760

NPI assigned

Aug 17, 2020

Organization subpart

No

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

Authorized official

Name

Ahmed Cali Adam

Title

Account Manager

Phone

(612) 978-0760

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604534400000",
    "number": "1295347854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 OLD HIGHWAY 8 STE 106B",
            "city": "ST. ANTHONY",
            "state": "MN",
            "postal_code": "55418",
            "telephone_number": "612-978-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 OLD HIGHWAY 8 STE 106B",
            "city": "ST. ANTHONY",
            "state": "MN",
            "postal_code": "55418",
            "telephone_number": "612-978-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINING LIGHT SKILL BUILDING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A",
        "authorized_official_last_name": "ADAM",
        "authorized_official_first_name": "AHMED",
        "authorized_official_middle_name": "CALI",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "612-978-0760"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faiza A Sheikhmohamed
• Abdifatah Sherif
• Ala Sherif
• Maymuna Sherif
• Yaelin Shim
• Silver Lake Clinic
• Snyders Drug (Snyder Drug Emporium)
• Anne Sorenson
• Spectrum Solution LLC
• St Anthony Optometric Clinic

• Cognitive & Behavioral Psychologist in St Anthony, MN
• Providers in St Anthony, MN by specialty
• Cognitive & Behavioral Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.