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General NPI Number Information
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NPI Number | 1326952524
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Entity Type | Organization
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Legal Business Name | SHINE (SUPPORTING HEALTH IN NAVIGATING EMOTIONS)
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Dates
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Enumeration Date | 10/02/2026
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Last Update Date | 10/02/2026
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Provider Practice Location Address
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Address Line | 201 E MAIN ST STE 202
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City | ABINGDON
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State | VA
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Zip | 24210-2903
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Country | US
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Telephone | 276-207-8577
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Fax |
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Provider Business Mailing Address
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Address Line | 2050 LEE HWY
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City | BRISTOL
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State | VA
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Zip | 24201-1626
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Country | US
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Telephone | 276-207-8577
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST (LIC)
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Name | LOGAN LOVE
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Credential | LMFT
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Telephone | 276-791-1712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | NULL
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