SHORES THERAPY, LLC (NPI# 1609255926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609255926 |
| Entity Type | Organization |
| Organization Name | SHORES THERAPY, LLC |
| Practice Address |
557 7th St W Saint Paul MN 55102-3065 |
| Mailing Address |
674 Ottawa Ave Saint Paul MN 55107-2555 |
| Practice Telephone | 6519004808 |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2015-05-19 |
| Authorized Official Name | DR. CRYSTAL SHORES (PSYCHOLOGIST) |
| Authorized Official Telephone | 6519004808 |
| Authorized Official Credential | PSYD, LP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | LP5721 | MN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396247482 | Shores Therapy, LLC | Clinic/Center | 358 Ne 105th St, Miami Shores, FL 33138-2022 | 2018-03-05 |
| Street Address |
557 7TH ST W |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55102-3065 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457497158 | Theresa L Del Rosario | Massage Therapist | 557 7th St W, Suite 6, Saint Paul, MN 55102-3065 | 2007-01-29 |
| 1164069068 | Krista Masek | Counselor | 557 7th St W, Saint Paul, MN 55102-3065 | 2019-12-10 |
| 1447818786 | Abby Jean Kowitz | Counselor | 557 7th St W, Saint Paul, MN 55102-3065 | 2019-06-02 |
| 1942782909 | Daniel Robert Mcclure | Psychologist | 557 7th St W, Saint Paul, MN 55102-3065 | 2018-09-05 |
| 1912394099 | Intentional Living, LLC | Counselor | 557 7th St W, Saint Paul, MN 55102-3065 | 2015-04-16 |
| 1427183094 | Lee Bradley Erickson | Counselor | 557 7th St W, Saint Paul, MN 55102-3065 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720623366 | Ning Wu | Acupuncturist | Tcm Health Center, 613 Grand Ave., St. Paul, MN 55102 | 2019-11-07 |
| 1730730615 | Tianwei Guo | Acupuncturist | 613 Grand Avenue, Saint Paul, MN 55102 | 2019-09-23 |
| 1194374850 | Justin Crawford Diehl | Counselor | 976 Juno Avenue, Saint Paul, MN 55102 | 2019-09-05 |
| 1699329169 | Elisabeth Johanna Wurtmann | Genetic Counselor, MS | 310 N Smith Avenue Suite 300, Saint Paul, MN 55102 | 2019-08-01 |
| 1265907083 | Lillia Budd | Nurse Practitioner | 225 Smith Ave N - Suite 400, Mail Route 65400, Saint Paul, MN 55102 | 2018-10-08 |
| 1922505098 | Women of Nations | Substance Abuse Rehabilitation Facility | 73 Leech Street, St. Paul, MN 55102 | 2018-04-06 |
| 1609371939 | Courtney Marie Klinkhammer | Student in an Organized Health Care Education/Training Program | 1026 West Seventh Street, St. Paul, MN 55102 | 2018-03-28 |
| 1427429372 | Compass Pathology and Consulting | Clinical Medical Laboratory | 360 Sherman St Suite 400b, St. Paul, MN 55102 | 2015-10-16 |
| 1639550494 | Daniel Delapp | Speech-Language Pathologist | United Hospital 333 Smith Avenue N, Mail Route 60104, St. Paul, MN 55102 | 2015-06-17 |
| 1124419940 | Suzanne Carl | Speech-Language Pathologist | 360 Colborne Avenue, St. Paul, MN 55102 | 2015-02-16 |
| Find all providers in zip 55102 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073161220 | Jeffrey Paul Olsen | Psychologist | 2275 Youngman Ave Ste 204, Saint Paul, MN 55116-3053 | 2019-08-30 |
| 1205496890 | Xenia Ewing | Psychologist | 1611 County Road B W Ste 214, Saint Paul, MN 55113-5021 | 2019-06-17 |
| 1316432867 | Lewis M Rambo | Psychologist | 624 Selby Ave Ste 2, Saint Paul, MN 55104-6614 | 2018-06-27 |
| 1215450622 | Margaret Kellogg, Inc | Psychologist | 241 Cleveland Ave S Ste 1b, Saint Paul, MN 55105-1255 | 2017-07-18 |
| 1104361971 | Ruth Markowitz Ma Lp | Psychologist | 1599 Selby Ave Ste 107, Saint Paul, MN 55104-6263 | 2017-01-03 |
| 1144624636 | Martin J. Schoen, Psy.d., L.L.C. | Psychologist | 2096 Fairways Ln, Saint Paul, MN 55113-3813 | 2014-10-13 |
| 1770863607 | Stacy Coleman Symons | Psychologist | 7582 Currell Blvd Ste 108, Saint Paul, MN 55125-8210 | 2011-08-23 |
| 1427364355 | Vanessa Rachelle Rempel | Psychologist | 241 Cleveland Ave S Ste B6, Saint Paul, MN 55105-1255 | 2010-08-30 |
| 1295060770 | Joseph Vincent Bailey | Psychologist | 1798 Hewitt Ave, Saint Paul, MN 55104-1129 | 2009-10-16 |
| 1205061785 | Rebecca Sarah White | Psychologist | 180 5th St E, Saint Paul, MN 55101-2672 | 2009-05-27 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55102 |
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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.