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NPI Code Detail

MEDICARE: LASHARA SHAW LCPC

MEDICARE: LASHARA SHAW LCPC
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
1251B00000XCase Management AgencyIL
2101Y00000XCounselorIL
3171M00000XCase Manager/Care CoordinatorIL
4225C00000XRehabilitation CounselorIL
5101YM0800XMental Health CounselorIL
6101YP2500XProfessional Counselor180.012750
7101YP1600XPastoral CounselorIL
8225400000XRehabilitation PractitionerIL

General Provider Information

NPI Number : 1972193936
Entity Type Code : Individual
Provider Name (Legal Business Name) : LASHARA SHAW LCPC
Provider Business Mailing Address
First Line : PO BOX 2041
Second Line :
City : JOLIET
State : IL
Zip : 60434-2041
Country : US
Telephone Number : 815-414-6498
Fax Number : 815-242-4202
Provider Business Practice Location Address
First Line : 1755 PARK ST STE 200
Second Line :
City : NAPERVILLE
State : IL
Zip : 60563-8404
Country : US
Telephone Number : 158-324-4367
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2021
Last Update Date : 12/18/2025

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