Shasta Minery, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC22698 Issued in ME

Practice address

1048 South St
Dover Foxcroft, ME 04426-1232

Phone

(207) 564-3000

Fax

(207) 422-7339

NPI assigned

Oct 17, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Health Affiliates Maine, LLC

  • Community/Behavioral Health Agency
  • Auburn, ME
  • NPI 1932413556
  Medicare reassignment NPD

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1740001353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405",
            "city": "TENANTS HARBOR",
            "state": "ME",
            "postal_code": "048600405",
            "telephone_number": "207-975-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1048 SOUTH ST",
            "city": "DOVER FOXCROFT",
            "state": "ME",
            "postal_code": "044261232",
            "telephone_number": "207-564-3000",
            "fax_number": "207-422-7339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 405",
            "address_purpose": "LOCATION",
            "city": "Tenants Harbor",
            "state": "ME",
            "postal_code": "048600405",
            "country_code": "US",
            "telephone_number": "207-975-3929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINERY",
        "first_name": "SHASTA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-17",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "LC22698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Miller
• Erin Jeanette Miller, PA-C
• Marie Dawn Miller, LCSW
• Sheila M Miller, OD
• Jason Mills
• Francis Peter Moore, RPT
• MRH Corp.
• MRH Corp.
• MRH Corp.
• Thomas Kenneth Murray, MD

• Mental Health Counselor in Dover Foxcroft, ME
• Providers in Dover Foxcroft, ME by specialty
• Mental Health Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.