Healthcare Provider Details

I. General information

NPI: 1982516423
Provider Name (Legal Business Name): SHINE THE LIGHT COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1287 DAKOTA DR
BOX ELDER SD
57719-2415
US

IV. Provider business mailing address

1287 DAKOTA DR
BOX ELDER SD
57719-2415
US

V. Phone/Fax

Practice location:
  • Phone: 605-519-3381
  • Fax:
Mailing address:
  • Phone: 605-519-3381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ANGELA S BANLEY
Title or Position: THERAPIST/OWNER
Credential: LPC-MH
Phone: 605-519-3381