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General NPI Number Information
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NPI Number | 1356291694
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Entity Type | Individual
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Provider Name | MAKAYLA SHAW LSW
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Gender | Female
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 809 COSHOCTON AVE STE I
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City | MOUNT VERNON
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State | OH
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Zip | 43050-1900
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Country | US
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Telephone | 866-534-2639
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Fax | 800-480-7578
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Provider Business Mailing Address
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Address Line | 6959 KINNEY RD
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City | MOUNT VERNON
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State | OH
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Zip | 43050-8534
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Country | US
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Telephone | 614-900-5954
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.2613403
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License Number State | OH
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