Shake It Off Recovery LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SHAKE IT OFF RECOVERY LLC

Practice address

10000 N 31St Ave Ste 307
Phoenix, AZ 85051-9582

Phone

(209) 219-6064

NPI assigned

Aug 10, 2021

Organization subpart

No

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

Authorized official

Name

Brooklynn Holt

Title

Owner

Phone

(209) 219-6064

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

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

• Brooklynnn June Holt

  • Mental Health Counselor
  • Phoenix, AZ
  • NPI 1609594399
  NPD

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629417600000",
    "number": "1982379103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6517 W GROSS AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850438502",
            "telephone_number": "209-219-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 N 31ST AVE STE 307",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850519582",
            "telephone_number": "209-219-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAKE IT OFF RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-10",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "BROOKLYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-219-6064"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "laptop",
            "affiliation": "N",
            "address_1": "10000 N 31st Ave Ste 307",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850519582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Syed K Shahryar, M.D.
• Shahvar LLC
• Devin Edwin Shahverdian, M.D.
• Ramsha Shaikh
• Sara Shaikh, DO
• Shake Rattle and Grow Music Therapy Services, L.L.C.
• Rida Shakeel
• Nardeen Ayoub Shaker, MD, DPM
• Stephanie Jasmine Shakespaere
• Sima B Shakiba, MD

• Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.