NPIMap

Organization Active NPI

Shine Forth LLC

  • Professional Counselor
  • Cheyenne, WY
National Provider Identifier
1528667201
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
SHINE FORTH LLC
Practice address
6710 Willshire Blvd
Cheyenne, WY 82009-2757
Phone
(719) 248-1789
Fax
(307) 514-1080
NPI assigned
Oct 22, 2020
Last updated
Oct 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Authorized official

Name
Judiann Bryant, LPCNPI 1235361221
Title
LPC/Provider
Phone
(719) 248-1789

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

6710 Willshire Blvd
Cheyenne, WY 82009-2757

Mailing address

6710 Willshire Blvd
Cheyenne, WY 82009-2757
Phone (719) 248-1789

Other identifiers 1

IdentifierTypeStateIssuer
153780600MedicaidWY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address judi_bryant@juno.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1528667201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6710 WILLSHIRE BLVD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820092757",
            "telephone_number": "719-248-1789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6710 WILLSHIRE BLVD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820092757",
            "telephone_number": "719-248-1789",
            "fax_number": "307-514-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINE FORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "JUDIANN",
        "authorized_official_title_or_position": "LPC/PROVIDER",
        "authorized_official_telephone_number": "719-248-1789",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153780600",
            "state": "WY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "judi_bryant@juno.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pdf, jpg, documents, excel or csv",
            "address_1": "6710 Willshire Blvd",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820092757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.