Shelly Kay Bynum

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1889 W Redlands Blvd
Redlands, CA 92373-3119

Phone

(909) 501-5167

NPI assigned

Jun 5, 2009

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Banning, CA
  • NPI 1376293407
  NPD (past)
• Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Redlands, CA
  • NPI 1992219646
  NPD (past)
• Changing Steps

  • Community/Behavioral Health Agency
  • Los Angeles, CA
  • NPI 1104040880
  NPD (past)
• Changing Steps, Inc.

  • Non-emergency Medical Transport (VAN)
  • Los Angeles, CA
  • NPI 1801196548
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 10, 2023.

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1508092461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1889 W REDLANDS BLVD BLDG 9",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923733119",
            "telephone_number": "909-501-5167",
            "fax_number": "909-801-8133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1889 W REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923733119",
            "telephone_number": "909-501-5167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYNUM",
        "first_name": "SHELLY",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-05",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Nicole Butcher
• Adrianna Butt
• Buxton Medical Enterprises
• Luke Buxton, DO
• Un Ji Byeoun, DDS
• C&C Center for Healing
• C&C Center for Healing
• C&C Center for Healing Licensed Clinical Social Worker Inc
• Aizel Mae Cabanatan
• Marvin Cabral, PHD

• All providers in Redlands, CA
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.