Provider Demographics
NPI:1386409308
Name:SHINE BRIGHT COUNSELING AND CONSULTING LLC
Entity type:Organization
Organization Name:SHINE BRIGHT COUNSELING AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITELEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-849-7690
Mailing Address - Street 1:PO BOX 452
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97709-0452
Mailing Address - Country:US
Mailing Address - Phone:458-899-4769
Mailing Address - Fax:
Practice Address - Street 1:150 SW 4TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1838
Practice Address - Country:US
Practice Address - Phone:458-899-4769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty