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General NPI Number Information
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NPI Number | 1811458748
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Entity Type | Individual
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Provider Name | AMELIA JEAN SHAW MSSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 1201 BROAD ROCK BLVD MEDICAL CENTER 652/122 SOCIAL WORK
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City | RICHMOND
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State | VA
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Zip | 23249-2305
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Country | US
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Telephone | 804-675-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 3200 WINCHESTER ST
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City | HENRICO
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State | VA
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Zip | 23231-2347
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Country | US
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Telephone | 937-546-3619
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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 | 0904013671
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 0009922206
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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