MEDICARE: BRITAIN LAINE SHAW

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	101YP2500X	Professional Counselor	87856	TX

General Provider Information

NPI Number	:	1780112011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITAIN LAINE SHAW

Provider Business Mailing Address
First Line	:	3449 S JEFFERSON AVE # 10
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63118-3119
Country	:	US
Telephone Number	:	314-312-1206
Fax Number	:

Provider Business Practice Location Address
First Line	:	3449 S JEFFERSON AVE # 10
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63118-3119
Country	:	US
Telephone Number	:	314-312-1206
Fax Number	:

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

Provider Enumeration Date	:	05/31/2017
Last Update Date	:	03/16/2026

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Directions to “ BRITAIN LAINE SHAW ” Practice Location

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