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General NPI Number Information
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NPI Number | 1750207593
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Entity Type | Organization
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Legal Business Name | SHIFT PLLC
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Dates
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Enumeration Date | 06/25/2026
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Last Update Date | 06/25/2026
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Provider Practice Location Address
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Address Line | 11208 PARKHILL PL NE
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-1323
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Country | US
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Telephone | 401-349-1371
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Fax |
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Provider Business Mailing Address
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Address Line | 10355 NE VALLEY RD UNIT 4466
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City | ROLLINGBAY
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State | WA
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Zip | 98061-0019
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Country | US
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Telephone | 401-349-1371
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MAIA COLLEEN MCCOY
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Credential | LICSW
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Telephone | 401-349-1371
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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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