Shadowed Mind Therapy, LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

SHADOWED MIND THERAPY, LLC

Practice address

11003 E 15TH Ave
Spokane Valley, WA 99206-2846

Phone

(208) 820-2310

Fax

(509) 381-3528

NPI assigned

Sep 14, 2021

Organization subpart

No

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

Authorized official

Name

Hiliary Beatty, MA, LMFTNPI 1659926863

Title

Marriage and Family Therapist/Owner

Phone

(208) 820-2310

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hiliary Beatty, MA, LMFT

  • Marriage & Family Therapist
  • Spokane, WA
  • NPI 1659926863
  NPD Authorized official

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1891465746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11003 E 15TH AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992062846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11003 E 15TH AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992062846",
            "telephone_number": "208-820-2310",
            "fax_number": "509-381-3528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADOWED MIND THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A",
        "authorized_official_last_name": "BEATTY",
        "authorized_official_first_name": "HILIARY",
        "authorized_official_title_or_position": "MARRIAGE AND FAMILY THERAPIST/OWNER",
        "authorized_official_telephone_number": "208-820-2310",
        "authorized_official_credential": "MA, LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "6517651",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kara Leanne Sevigny
• Leandra Sexton
• Justin David Seymour, MD
• Maree Shabeesh
• Kimberly Dawn Shaddox, M.S., L.AC, DIPL. AC
• Shafer Anesthesia, LLC
• Nasreen S Shah
• Alina E Shanin, SUDPT
• Sharing Grace Counseling
• Ashish Prakash Sharma, BDS, MSD

• Marriage & Family Therapist in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.