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General NPI Number Information
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NPI Number | 1083578744
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Entity Type | Individual
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Provider Name | HARRISON SHAW
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Gender | Male
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Dates
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Enumeration Date | 12/16/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 652 GRANGER RD STE 1
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City | BARRE
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State | VT
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Zip | 05641-5363
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Country | US
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Telephone | 802-229-9151
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Fax |
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Provider Business Mailing Address
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Address Line | 59 E STATE ST APT 3
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City | MONTPELIER
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State | VT
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Zip | 05602-3078
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 156.0134279
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License Number State | VT
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