Shawn Raley

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

260005 Issued in KY

Practice address

9111 Cross Park Dr
E475
Knoxville, TN 37923-4506

Phone

(865) 560-2550

NPI assigned

Jul 28, 2016

Last updated

Jun 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Youth Villages

  • Mental Health Counselor
  • Knoxville, TN
  • NPI 1942349121
  NPD (past)

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1346793189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9111 CROSS PARK DR",
            "address_2": "E475",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9111 CROSS PARK DR",
            "address_2": "E475",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234506",
            "telephone_number": "865-560-2550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Alpine Dr",
            "address_purpose": "LOCATION",
            "city": "Shelbyville",
            "state": "KY",
            "postal_code": "400658880",
            "country_code": "US",
            "telephone_number": "502-589-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RALEY",
        "first_name": "SHAWN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-28",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "260005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilson T Raines, PT
• Darren Michael Rainwater
• Madison Shea Rainwater
• Nemin Maxwell Rajan, M.D.
• Ashely Nicole Raley, APRN, FNP-C
• Jaden Ralph
• Nancy Hill Ralston, CRNA
• Ronnie Ramadan, M.D.
• Edye M Ramaglia
• Christina G Raman, APRN, BC

• Professional Counselor in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Professional Counselor in Tennessee

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