Individual provider Active NPI

John Devin Shorey, LMHC, RMFTI

  • Mental Health Counselor
  • Trenton, FL
National Provider Identifier
1417566464
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
19625 Issued in FL
Practice address
728 NE 7TH St
Trenton, FL 32693-3637
Phone
(352) 374-5600
NPI assigned
Jul 27, 2020
Last updated
Aug 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 19625 FL Primary
Marriage & Family Therapist 106H00000X 3069 FL

Addresses

Primary practice location

728 NE 7TH St
Trenton, FL 32693-3637

Mailing address

1001 NE 16TH Ave
Gainesville, FL 32601-2511
Phone (352) 448-9120

Other practice location 1

1001 NE 16th Ave
Gainesville, FL 32601-2511
Phone (352) 448-9120

Other practice location 2

103 NE 1st St
Chiefland, FL 32626-0920
Phone (352) 374-5600 ext. 8860

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
19625FLMDMental Health Counselor
3069FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gainesville Community Counseling Center Marriage & Family Therapist PastSince Aug 1, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1417566464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 NE 16TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326012511",
            "telephone_number": "352-448-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 NE 7TH ST",
            "city": "TRENTON",
            "state": "FL",
            "postal_code": "326933637",
            "telephone_number": "352-374-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 NE 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326012511",
            "country_code": "US",
            "telephone_number": "352-448-9120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "103 NE 1st St",
            "address_purpose": "LOCATION",
            "city": "Chiefland",
            "state": "FL",
            "postal_code": "326260920",
            "country_code": "US",
            "telephone_number": "352-374-5600 x8860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOREY",
        "first_name": "JOHN",
        "middle_name": "DEVIN",
        "credential": "LMHC, RMFTI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "19625",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "3069",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.