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General NPI Number Information
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NPI Number | 1144962507
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Entity Type | Organization
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Legal Business Name | ANDREW SHAW COUNSELING AND CONSULTING, PLLC
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Dates
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Enumeration Date | 04/07/2022
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 4030 WAKE FOREST RD STE 349
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City | RALEIGH
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State | NC
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Zip | 27609-0010
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Country | US
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Telephone | 919-436-1817
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Fax | 919-578-5025
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Provider Business Mailing Address
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Address Line | PMB 770 4801 GLENWOOD AVE STE 200
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City | RALEIGH
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State | NC
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Zip | 27612-3857
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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 | MEMBER ORGANIZER
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Name | ANDREW MICHAEL SHAW
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Credential | LCMHC
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Telephone | 919-436-1817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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