DR. JACK WILLIAM SHAW ED.D. LMHC NPI 1124623319

NPI Information

NPI: 1124623319
Provider Name: DR. JACK WILLIAM SHAW, ED.D., LMHC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
1735 DR MLK JR STREET SOUTH
ST PETERSBURG, FL
ZIP 33705
Phone: (727) 502-0188
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DR. Jack William Shaw, ED.D., LMHC is a mental health counselor in St Petersburg, FL. DR. Jack William Shaw, ED.D., LMHC NPI is 1124623319. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1735 DR MLK JR STREET SOUTH
ST PETERSBURG, FL
ZIP 33705-547
Phone: (727) 502-0188

The enumeration date for this NPI number is 12/3/2020 and was last updated on 11/2/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	MCAP100243	FLORIDA	No
2	101YM0800X	Counselor	Mental Health	MH21197	FLORIDA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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