MEDICARE: SHINE NOW PSYCHIATRIC SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1770415093
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHINE NOW PSYCHIATRIC SERVICES

Provider Business Mailing Address
First Line	:	1002 N WOODLAND DR STE B
Second Line	:
City	:	LANCASTER
State	:	SC
Zip	:	29720-1966
Country	:	US
Telephone Number	:	803-866-3555
Fax Number	:	803-373-8917

Provider Business Practice Location Address
First Line	:	1002 N WOODLAND DR STE B
Second Line	:
City	:	LANCASTER
State	:	SC
Zip	:	29720-1966
Country	:	US
Telephone Number	:	803-866-3555
Fax Number	:	803-373-8917

Authorized Official
Title or Position	:	OWNER
Name	:	MELISSA W. PATE
Credential	:	MSN, PMHNP
Telephone Number	:	803-416-2672

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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