SHADLYN C BOURNE (NPI# 1710526637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710526637 |
| Entity Type | Individual |
| Full Name | SHADLYN C BOURNE |
| Credential | LPCC |
| Practice Address |
9800 Shelard Pkwy Ste 325 Plymouth MN 55441-6453 |
| Mailing Address |
4007 65th Ave N Brooklyn Center MN 55429-2158 |
| Practice Telephone | 7636146393 |
| Mailing Telephone | 7636146393 |
| Enumeration Date | 2019-12-23 |
| Last Update Date | 2019-12-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
9800 SHELARD PKWY STE 325 |
| City | PLYMOUTH |
| State | MN |
| Zip Code | 55441-6453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487145546 | African American Child Wellness Institute | Clinic/Center | 9800 Shelard Pkwy Ste 325, Plymouth, MN 55441-6453 | 2018-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689190019 | The Recovery Clinic LLC | Clinic/Center | 9800 Shelard Pkwy Ste 215, Plymouth, MN 55441 | 2017-08-17 |
| 1356887186 | Katherine Marlow Bell | Dentist | 2805 Campus Dr Ste 245, Plymouth, MN 55441 | 2017-01-18 |
| 1083069538 | Mercade Waldon | Home Health Aide | 3501 Xenium Lane, Plymouth, MN 55441 | 2016-05-03 |
| 1346645538 | Phs Westhealth, Inc | Skilled Nursing Facility | 2775 Campus Drive North, Plymouth, MN 55441 | 2014-10-30 |
| 1427453125 | Samuel David Fine | Pharmacist | 4070 Goldenrod Ln, Plymouth, MN 55441 | 2014-10-24 |
| 1548672538 | Scott Aaron Schmidt | Dentist | 2720 Annapolis Circle N, Suite A, Plymouth, MN 55441 | 2014-05-23 |
| 1831498633 | Comforide Transportation Services LLC | Non-emergency Medical Transport (VAN) | 9730 37th Pl N Suite 201, Plymouth, MN 55441 | 2011-03-18 |
| 1255669271 | Tammy Kae Mehlhaus | Physician Assistant | 2855 Campus Drive, Suite 570, Plymouth, MN 55441 | 2009-12-02 |
| 1164758199 | Stephen P. Boger, Dds, Pa | Dentist | 2720 Annapolis Circle, Suite A, Plymouth, MN 55441 | 2009-10-27 |
| 1093908360 | Endodontic Professionals Pa Plymouth Endodontics | Dentist | 3401 Hwy 169 N, Plymouth, MN 55441 | 2007-08-21 |
| Find all providers in zip 55441 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174124648 | Sedonia Counseling Services, LLC | Counselor | 10812 Cardinal Cir, Plymouth, IN 46563-7968 | 2020-11-02 |
| 1992329676 | Ann Kowalski | Counselor | 1259 Old Sandwich Rd, Plymouth, MA 02360-2516 | 2020-05-29 |
| 1497378780 | Juli Lynn Sneider | Counselor | 23 South St Apt 5, Plymouth, MA 02360-2984 | 2020-05-21 |
| 1588218440 | Kyle Hochstin | Counselor | 5 Jacobs Ladder, Plymouth, MA 02360-2115 | 2019-07-30 |
| 1700444635 | Abstract Therapy LLC. | Counselor | 5 Main Street Ext Ste 303, Plymouth, MA 02360-3390 | 2019-06-05 |
| 1902360209 | Shari Cimino Pllc | Counselor | 42225 Ann Arbor Rd E, Plymouth, MI 48170-4364 | 2019-01-31 |
| 1699243667 | Macayla Kelley | Counselor | 70 Ellisville Grn, Plymouth, MA 02360-1742 | 2018-11-08 |
| 1023593605 | Gail Baran Good | Counselor | 13896 Covington Dr, Plymouth, MI 48170-2449 | 2018-09-28 |
| 1972085066 | Brandon Welch | Counselor | 12 Anchor Dr, Plymouth, MA 02360-3202 | 2018-09-05 |
| 1609393842 | Kathleen Morton Hicks | Counselor | 64 Industrial Park Rd Ste B, Plymouth, MA 02360-4881 | 2017-08-28 |
| Find all providers in PLYMOUTH | ||||
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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.