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General NPI Number Information
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NPI Number | 1336833508
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Entity Type | Individual
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Provider Name | KRISTINA SHAW LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 06/08/2023
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 1396 PICCARD DR
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City | ROCKVILLE
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State | MD
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Zip | 20850-4302
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Country | US
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Telephone | 301-448-0606
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Fax |
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Provider Business Mailing Address
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Address Line | 8611 HUNTERS DR
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City | FREDERICK
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State | MD
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Zip | 21701-2613
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Country | US
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Telephone | 240-446-7304
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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 | LC200003418
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 22727
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904017005
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License Number State | VA
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