MIND SHINE, LLC (NPI# 1558878082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558878082 |
| Entity Type | Organization |
| Organization Name | MIND SHINE, LLC |
| Practice Address |
8360 Six Forks Rd Raleigh NC 27615-5077 |
| Mailing Address |
8360 Six Forks Rd Ste 102 Raleigh NC 27615-5087 |
| Practice Telephone | 9197584559 |
| Mailing Telephone | 9197584559 |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2018-01-05 |
| Authorized Official Name | SABRIYA LAILA SHARIF-HANIFA (CEO) |
| Authorized Official Telephone | 9197584559 |
| Authorized Official Credential | MS, LCASA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 3175-A | NC | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871022988 | Mind Shine, LLC | Counselor | 8360 Six Forks Rd Ste 102, Raleigh, NC 27615-5087 | 2017-06-12 |
| Street Address |
8360 SIX FORKS RD |
| City | RALEIGH |
| State | NC |
| Zip Code | 27615-5077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902882632 | Michael Robert Volow | Psychiatry & Neurology | 8360 Six Forks Rd, Suite 202, Raleigh, NC 27615-5077 | 2005-12-15 |
| 1679501977 | Harold Lee Williams | Psychologist | 8360 Six Forks Rd, Suite 202, Raleigh, NC 27615-5077 | 2006-06-28 |
| 1902832801 | Lisa Birl Hasan | Physician Assistant | 8360 Six Forks Rd, Suite 202, Raleigh, NC 27615-5077 | 2006-06-23 |
| 1356386486 | Melvania Eloisa Briggs | Physician Assistant | 8360 Six Forks Rd, Raleigh, NC 27615-5077 | 2006-06-20 |
| 1164477691 | Myleme Ojina Harrison | Psychiatry & Neurology | 8360 Six Forks Rd, Ste 202, Raleigh, NC 27615-5077 | 2006-05-23 |
| 1861444804 | Robert Francis Fearnot | Psychiatry & Neurology | 8360 Six Forks Rd, Suite 202, Raleigh, NC 27615-5077 | 2006-05-17 |
| 1881647451 | Titus Haynes | Social Worker | 8360 Six Forks Rd, Suite 202, Raleigh, NC 27615-5077 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588278535 | Emily Grace Johnson | Behavior Technician | 119 Wind Chime Court, Suite 4, Raleigh, NC 27615 | 2020-09-06 |
| 1730706110 | Maja V Martin, Dds, Pa1 | Clinic/Center | 7371 Six Forks Road, Raleigh, NC 27615 | 2020-07-01 |
| 1972146967 | Atlantic Avenue Pharmaceutical, Inc | Pharmacy | 5621 Atlantic Ave, Suite 103, Raleigh, NC 27615 | 2019-10-22 |
| 1023503950 | Siyara Shannay Dobbs | Social Worker | 7013 Woodbend Dr Apt H, Raleigh, NC 27615 | 2018-06-23 |
| 1194210153 | Brittanie Ja'nell Harris | Dentist | 1911 Falls Valley Dr Ste 107, Raleigh, NC 27615 | 2018-06-22 |
| 1710489448 | Sherise Swensen | Social Worker | 8368 Six Forks Road, Suite 101, Raleigh, NC 27615 | 2018-03-08 |
| 1881100345 | Casey Paul Baine | Counselor | 6330 Falls of Neuse Rd Ste 104, Raleigh, NC 27615 | 2017-12-20 |
| 1588177885 | Michael Lacidonia | Acupuncturist | 6400 Falls of Neuse Rd Ste 200, Raleigh, NC 27615 | 2017-11-08 |
| 1457877631 | Matt Henderson | Behavioral Analyst | 8374 Six Forks Road, Suite 101, Raleigh, NC 27615 | 2017-08-18 |
| 1760907646 | Shakeda Muldrow | Social Worker | 7323 Brookbank Lane, Raleigh, NC 27615 | 2017-08-11 |
| Find all providers in zip 27615 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528688678 | Life Extensions LLC | Community/Behavioral Health | 4304 Coburn Pl Apt 106, Raleigh, NC 27616-7971 | 2020-04-19 |
| 1639716368 | Monarch | Community/Behavioral Health | 1705 Beacon Bluff St, Raleigh, NC 27604-5446 | 2019-12-02 |
| 1700429396 | Transcending Limits Counseling Services Pllc | Community/Behavioral Health | 3445 Teravista Way, Raleigh, NC 27616-9310 | 2019-10-25 |
| 1497397137 | Ever-lasting Counseling Service LLC | Community/Behavioral Health | 7730 Sunfield Cir Apt 303, Raleigh, NC 27617-6762 | 2019-10-15 |
| 1285108373 | Metro Treatment of North Carolina L P | Community/Behavioral Health | 3911 New Bern Ave, Raleigh, NC 27610-1332 | 2019-01-11 |
| 1932670999 | Elevation Community Services, LLC | Community/Behavioral Health | 3712 Benson Dr Ste 201-202, Raleigh, NC 27609-7328 | 2018-12-16 |
| 1891297222 | Saving Hope, LLC | Community/Behavioral Health | 2501 Lilymount Dr, Raleigh, NC 27610-3476 | 2018-03-01 |
| 1508370776 | Resiliency In Recovery | Community/Behavioral Health | 3986 Cane Garden Dr, Raleigh, NC 27610-5696 | 2017-11-27 |
| 1467975318 | Aci Support Specialists, LLC | Community/Behavioral Health | 6832 Planting Ct, Raleigh, NC 27610-8705 | 2017-07-24 |
| 1134649601 | Aci Support Specialists, LLC | Community/Behavioral Health | 12367 Honeychurch St, Raleigh, NC 27614-7879 | 2017-06-26 |
| Find all providers in RALEIGH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.