Healthcare Provider Details

I. General information

NPI: 1144980764
Provider Name (Legal Business Name): SHAME FREE THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2021
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 GRAMATAN AVE
MOUNT VERNON NY
10552-3244
US

IV. Provider business mailing address

410 GRAMATAN AVE
MOUNT VERNON NY
10552-3244
US

V. Phone/Fax

Practice location:
  • Phone: 650-930-6471
  • Fax:
Mailing address:
  • Phone: 650-930-6471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: RACHEL GIBBS WRIGHT
Title or Position: OWNER
Credential: MA, LMFT
Phone: 650-930-6471