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General NPI Number Information
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NPI Number | 1962160390
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Entity Type | Organization
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Legal Business Name | CHARITY SHAW-MOYADO, LLC
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Dates
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Enumeration Date | 12/02/2021
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 3060 OGDEN AVE STE 301
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City | LISLE
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State | IL
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Zip | 60532-1685
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Country | US
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Telephone | 773-270-3522
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Fax |
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Provider Business Mailing Address
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Address Line | 76 BUNTING LN
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City | NAPERVILLE
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State | IL
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Zip | 60565-1333
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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 | OWNER
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Name | CHARITY SHAW-MOYADO
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Credential | LCSW
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Telephone | 773-270-3522
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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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