Active NPI
Anna Katherine Shine, MA, LPC-A
- Professional Counselor
- Bryan, TX
National Provider Identifier
1295457992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 87967
- Practice address
- 1401 Sandia PLZ
Bryan, TX 77802-4356 - Phone
- (281) 782-7871
- NPI assigned
- Sep 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 87967 | TX | Primary |
Addresses
Primary practice location
1401 Sandia PLZ
Bryan, TX 77802-4356
Mailing address
1703 Summerwood Loop
Bryan, TX 77807-1103
Phone (281) 782-7871
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 87967 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663545600000",
"number": "1295457992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1703 SUMMERWOOD LOOP",
"city": "BRYAN",
"state": "TX",
"postal_code": "778071103",
"telephone_number": "281-782-7871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 SANDIA PLZ",
"city": "BRYAN",
"state": "TX",
"postal_code": "778024356",
"telephone_number": "281-782-7871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHINE",
"first_name": "ANNA",
"middle_name": "KATHERINE",
"name_prefix": "Mrs.",
"credential": "MA, LPC-A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-19",
"last_updated": "2022-09-19",
"certification_date": "2022-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "TX",
"license": "87967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bryan, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.