Shine a Light Foundation

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Legal business name

SHINE A LIGHT FOUNDATION

Practice address

2330 Highland Dr Ste 205
Las Vegas, NV 89102-4810

Phone

(725) 222-4654

NPI assigned

Apr 20, 2023

Organization subpart

No

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

Authorized official

Name

Jimmy Durbin, LCSW

Title

Clinical Supervisor

Phone

(702) 883-4464

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1629765599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 HIGHLAND DR STE 205",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891024810",
            "telephone_number": "702-863-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 HIGHLAND DR STE 205",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891024810",
            "telephone_number": "725-222-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINE A LIGHT FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-20",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "DURBIN",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "702-883-4464",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kwang Chul Shin, M.D.
• Sang M Shin
• Thomas Shin
• Young S Shin
• Kazeem Shinaba II
• Shine Bright Behavioral Health, L.L.C.
• Shine Home Care
• Jonathan Shine
• Laura Shingary
• Shining Light Counseling LLC

• Case Manager/Care Coordinator in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Case Manager/Care Coordinator in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.