Individual provider Active NPI

Shiloh Everidge, LLPC

  • Mental Health Counselor
  • Midland, MI
National Provider Identifier
1629545231
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6451019691 Issued in MI
Practice address
5816 Eastman Ave
Midland, MI 48640-6792
Phone
(989) 244-1888
Fax
(989) 321-6544
NPI assigned
Nov 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6451019691 MI Primary

Addresses

Primary practice location

5816 Eastman Ave
Midland, MI 48640-6792

Mailing address

5816 Eastman Ave
Midland, MI 48640-6792
Phone (989) 244-1888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6451019691MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Renewal Christian Counseling Inc Mental Health CurrentSince Oct 31, 2021 Accepting new patients
Peace River Center for Personal Development Inc PastSince Feb 1, 2022 Accepting new patients
Peace River Center for Personal Development Inc PastSince Feb 1, 2022 Accepting new patients

Locations

5816 Eastman Ave
Midland, MI 48640
Phone (989) 244-1888

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1629545231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5816 EASTMAN AVE",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406792",
            "telephone_number": "989-244-1888",
            "fax_number": "989-321-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5816 EASTMAN AVE",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406792",
            "telephone_number": "989-244-1888",
            "fax_number": "989-321-6544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERIDGE",
        "first_name": "SHILOH",
        "credential": "LLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-01",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451019691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.