Innershine Associates, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

149.018437 Issued in IL

Legal business name

INNERSHINE ASSOCIATES, LLC

Practice address

723 W 111TH St
Chicago, IL 60628-3902

Phone

(312) 218-8568

Fax

(773) 643-8649

NPI assigned

Jan 3, 2017

Last updated

Jan 28, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joan D McCohnell, PH.DNPI 1265972962

Title

Ceo/Clinical Therapist

Phone

(312) 218-8568

Specialties & licenses 1

Addresses

Other names 1

• InnerShine Associates, LLC Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joan D McCohnell, PHD, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1265972962
  NPD Authorized official

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548633600000",
    "number": "1437694254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7131 S. CONSTANCE AVE.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606492326",
            "telephone_number": "312-218-8568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606283902",
            "telephone_number": "312-218-8568",
            "fax_number": "773-643-8649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNERSHINE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-03",
        "last_updated": "2019-01-28",
        "status": "A",
        "authorized_official_last_name": "MCCOHNELL",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO/CLINICAL THERAPIST",
        "authorized_official_telephone_number": "312-218-8568",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "149.018437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "InnerShine Associates, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; 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.