Shine Bright Behavioral Health, L.L.C.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SHINE BRIGHT BEHAVIORAL HEALTH, L.L.C.

Practice address

5020 Alta Dr Ste D
Las Vegas, NV 89107-3940

Phone

(725) 400-1888

NPI assigned

Mar 2, 2021

Organization subpart

No

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

Authorized official

Name

Fayrene Victoriano

Title

Consultant

Phone

(725) 400-1888

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1639764541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N RAINBOW BLVD STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071190",
            "telephone_number": "702-374-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5020 ALTA DR STE D",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891073940",
            "telephone_number": "725-400-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINE BRIGHT BEHAVIORAL HEALTH, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "VICTORIANO",
        "authorized_official_first_name": "FAYRENE",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "725-400-1888"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sang M Shin
• Thomas Shin
• Young S Shin
• Kazeem Shinaba II
• Shine a Light Foundation
• Shine Home Care
• Jonathan Shine
• Laura Shingary
• Shining Light Counseling LLC
• Shining Light LLC

• Clinical Social Worker in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.