Mind Shine, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

3175-A Issued in NC

Legal business name

MIND SHINE, LLC

Practice address

8360 Six Forks Rd
Raleigh, NC 27615-5077

Phone

(919) 758-4559

NPI assigned

Jan 5, 2018

Last updated

Jan 5, 2018By 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

Sabriya Laila Sharif-Hanifa, MS, LCASANPI 1114361797

Title

Ceo

Phone

(919) 758-4559

Specialties & licenses 1

Addresses

Locations

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.

• Sabriya Laila Sharif-Hanifa, MS, LCAS-A

  • Addiction (Substance Use Disorder) Counselor
  • Knightdale, NC
  • NPI 1114361797
  NPD Authorized official

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515110400000",
    "number": "1558878082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8360 SIX FORKS RD STE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276155087",
            "telephone_number": "919-758-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8360 SIX FORKS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276155077",
            "telephone_number": "919-758-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND SHINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-05",
        "last_updated": "2018-01-05",
        "status": "A",
        "authorized_official_last_name": "SHARIF-HANIFA",
        "authorized_official_first_name": "SABRIYA",
        "authorized_official_middle_name": "LAILA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-758-4559",
        "authorized_official_credential": "MS, LCASA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "3175-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Minacho
• Aster Marie-Grace Minani, MS, OTR/L
• Marie E Minani, MPHNP-BC
• Mind & Body Therapeutic Services PLLC
• Mind Peak Counseling, PLLC
• Mind Shine, LLC
• Mind What Matters Psychotherapy, PLLC
• Mindful Counseling and Wellness PLLC
• Mindful Growth Psychiatry
• Mindful Healing Group

• Community/Behavioral Health Agency in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2018; 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.