Shoreline Counseling, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

002446 Issued in CT

Legal business name

SHORELINE COUNSELING, LLC

Practice address

701 Wilcox Road Suite 107F
Stonington, CT 06378-2614

Phone

(401) 226-7407

NPI assigned

Mar 10, 2014

Organization subpart

No

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

Authorized official

Name

Justin Mink, LPC

Title

Owner

Phone

(401) 226-7407

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394409600000",
    "number": "1972929396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 WILCOX ROAD",
            "address_2": "SUITE 107F",
            "city": "STONINGTON",
            "state": "CT",
            "postal_code": "06378",
            "telephone_number": "401-226-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 WILCOX ROAD SUITE 107F",
            "city": "STONINGTON",
            "state": "CT",
            "postal_code": "063782614",
            "telephone_number": "401-226-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-10",
        "last_updated": "2014-03-10",
        "status": "A",
        "authorized_official_last_name": "MINK",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-226-7407",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "002446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Stonington, CT
• Providers in Stonington, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.