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General NPI Number Information
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NPI Number | 1548524739
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Entity Type | Individual
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Provider Name | CASEY PATRICIA SHAW LPC
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Gender | Female
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Dates
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Enumeration Date | 07/02/2012
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 202 MAKINAW RD
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City | HUTTO
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State | TX
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Zip | 78634-2711
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Country | US
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Telephone | 860-601-1245
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Fax |
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Provider Business Mailing Address
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Address Line | 202 MAKINAW RD
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City | HUTTO
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State | TX
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Zip | 78634-2711
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Country | US
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Telephone | 860-601-1245
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 002405
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License Number State | CT
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Taxonomy #2
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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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Taxonomy #3
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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 | TX
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