Healthcare Provider Details

I. General information

NPI: 1134055171
Provider Name (Legal Business Name): SHINE BRIGHT COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 COURT STREET #200
JACKSONVILLE NC
28540
US

IV. Provider business mailing address

216 BRYNN MARR RD # 179
JACKSONVILLE NC
28546-5705
US

V. Phone/Fax

Practice location:
  • Phone: 305-303-8775
  • Fax:
Mailing address:
  • Phone: 305-303-8775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. STEPHANIE LEE CARTER
Title or Position: PRESIDENT
Credential: LCMHC, LCAS-A
Phone: 305-303-8775