Provider Demographics
NPI:1194565382
Name:SHINE BRIGHT COUNSELING
Entity type:Organization
Organization Name:SHINE BRIGHT COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RECKART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-880-0182
Mailing Address - Street 1:30 SINE PL
Mailing Address - Street 2:
Mailing Address - City:BRUCETON MILLS
Mailing Address - State:WV
Mailing Address - Zip Code:26525-7410
Mailing Address - Country:US
Mailing Address - Phone:724-880-0182
Mailing Address - Fax:
Practice Address - Street 1:30 SINE PL
Practice Address - Street 2:
Practice Address - City:BRUCETON MILLS
Practice Address - State:WV
Practice Address - Zip Code:26525-7410
Practice Address - Country:US
Practice Address - Phone:724-880-0182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty