Active NPI
Shoray Kirk, LPC
- Professional Counselor
- Knoxville, TN
National Provider Identifier
1770511800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC1508
- Practice address
- 108 W Summit Hill Dr
Knoxville, TN 37902 - Phone
- (865) 525-1099
- Fax
- (865) 525-7494
- NPI assigned
- Jun 29, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC1508 | TN | Primary |
Addresses
Primary practice location
108 W Summit Hill Dr
Knoxville, TN 37902
Mailing address
108 W Summit Hill Dr
Knoxville, TN 37902
Phone (865) 525-1099
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5441092 | Medicaid | TN | |
| 4076057 | Other | TN | BCBS TN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| LPC1508 | TN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214956800000",
"number": "1770511800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 W SUMMIT HILL DR",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "37902",
"telephone_number": "865-525-1099",
"fax_number": "865-525-7494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 W SUMMIT HILL DR",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "37902",
"telephone_number": "865-525-1099",
"fax_number": "865-525-7494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRK",
"first_name": "SHORAY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-29",
"last_updated": "2008-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "LPC1508",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5441092",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS TN",
"identifier": "4076057",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.