Shining Bright Wellness PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SHINING BRIGHT WELLNESS PLLC

Practice address

3547 N Pulaski Rd
Chicago, IL 60641-3945

Phone

(815) 751-6439

NPI assigned

Mar 27, 2022

Organization subpart

No

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

Authorized official

Name

Shawna Johnson, LCSWNPI 1154823268

Title

Owner

Phone

(815) 751-6439

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.

• Shawna Johnson, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1154823268
  NPD Authorized official

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

{
    "created_epoch": "1648339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648339200000",
    "number": "1700536299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 S PRAIRIE AVE UNIT H",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053350",
            "telephone_number": "815-751-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3547 N PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606413945",
            "telephone_number": "815-751-6439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1502 S Prairie Ave Unit H",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606053350",
            "country_code": "US",
            "telephone_number": "815-751-6439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHINING BRIGHT WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-27",
        "last_updated": "2022-03-27",
        "certification_date": "2022-03-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHAWNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-751-6439",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pallavi Vilas Shinde, MS,PT
• Josette Shine, LCPC
• Rachel Shine
• Jill Eden Shiner
• Suresh Vrajlal Shingala, MD
• Shining Light Therapy
• Susan M Shinkus, RN
• Daniel Jinsup Shinn
• Peter Cuauhtemoc Shinnick, PHARMD
• Zak Andre Shinton, MD

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2022; 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.