Shores Therapy, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP5721 Issued in MN

Legal business name

SHORES THERAPY, LLC

Practice address

557 7TH St W
Saint Paul, MN 55102-3065

Phone

(651) 900-4808

NPI assigned

May 19, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Crystal Shores, PSYD, LP

Title

Psychologist

Phone

(651) 900-4808

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431993600000",
    "number": "1609255926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "674 OTTAWA AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551072555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 7TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551023065",
            "telephone_number": "651-900-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORES THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-19",
        "last_updated": "2015-05-19",
        "status": "A",
        "authorized_official_last_name": "SHORES",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "651-900-4808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP5721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bella Shklyarova, MD
• Barbara Jean Shock, MA, LMFT
• Terra Shockman, MD
• Adeline Sholar, RD, LD
• Sholom Home East Inc
• Brenda Shores, LICSW
• Casi Marie Short, CRNA
• Shoshana Center for Reproductive Health Psychology, PLLC
• Carol Jeanne Showalter, MD
• Jason Showers, LADC

• Psychologist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; 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.