MEDICARE: MS. SHARON V SHAW LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	MH 4278	FL

General Provider Information

NPI Number	:	1538225396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHARON V SHAW LMHC

Provider Business Mailing Address
First Line	:	PO BOX 7412
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33673-7412
Country	:	US
Telephone Number	:	813-382-1902
Fax Number	:	813-227-9399

Provider Business Practice Location Address
First Line	:	308 E OAK AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-2344
Country	:	US
Telephone Number	:	813-382-1902
Fax Number	:	813-227-9399

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	07/08/2007

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