Healthcare Provider Details

I. General information

NPI: 1750207593
Provider Name (Legal Business Name): SHIFT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11208 PARKHILL PL NE
BAINBRIDGE ISLAND WA
98110-1323
US

IV. Provider business mailing address

10355 NE VALLEY RD UNIT 4466
ROLLINGBAY WA
98061-0019
US

V. Phone/Fax

Practice location:
  • Phone: 401-349-1371
  • Fax:
Mailing address:
  • Phone: 401-349-1371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MAIA COLLEEN MCCOY
Title or Position: THERAPIST
Credential: LICSW
Phone: 401-349-1371