MEDICARE: MYA SHAW

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	1041C0700X	Clinical Social Worker	44SL07464700	NJ

General Provider Information

NPI Number	:	1801729074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYA SHAW

Provider Business Mailing Address
First Line	:	127 TYLER RD
Second Line	:
City	:	CORBIN CITY
State	:	NJ
Zip	:	08270-9627
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	208 N MAIN ST
Second Line	:
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-2122
Country	:	US
Telephone Number	:	609-486-2003
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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Directions to “ MYA SHAW ” Practice Location

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