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General NPI Number Information
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NPI Number | 1386409308
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Entity Type | Organization
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Legal Business Name | SHINE BRIGHT COUNSELING AND CONSULTING LLC
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Dates
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Enumeration Date | 02/19/2024
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | 150 SW 4TH ST
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City | REDMOND
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State | OR
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Zip | 97756-1838
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Country | US
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Telephone | 458-899-4769
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 452
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City | BEND
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State | OR
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Zip | 97709-0452
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Country | US
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Telephone | 458-899-4769
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Fax |
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Authorized Official
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Title or Position | PRACTITIONER
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Name | LIANA WHITELEY
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Credential |
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Telephone | 510-849-7690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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