SCOTT R SHAW (NPI# 1245363282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245363282 |
| Entity Type | Individual |
| Full Name | SCOTT R SHAW |
| Credential | LSW, CADC |
| Practice Address |
12 Health Services Dr Dekalb IL 60115-9637 |
| Practice Telephone | 8157564875 |
| Practice Fax Number | 8157562944 |
| Mailing Telephone | 8157564875 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
25526 | IL | Behavioral Health & Social Service Providers |
| X | 104100000X | Social Worker | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992930226 | Scott Gallagher Shaw | Dentist | 2704 171st Pl Ne, Marysville, WA 98271 | 2009-05-15 |
| 1487816351 | Scott Shaw | Physical Therapy Assistant | 2 Lucille Ln, Cherry Hill, NJ 08003-1031 | 2008-07-01 |
| 1629184759 | Scott Warren Shaw | Chiropractor | 10486 Ridgefield Pkway, Richmond, VA 23233 | 2006-08-22 |
| 1831147644 | Scott James Shaw | Specialist/Technologist | 18111 Nordhoff St., Northridge, CA 91330-8276 | 2006-05-04 |
| 1801945324 | Scott D. Shaw | Counselor | 3501 Lake Eastbrook Blvd Se, Suite 280, Grand Rapids, MI 49546-5938 | 2007-01-10 |
| 1053476986 | Scott Shaw | Physical Therapist | 22 Tompkins St, Waterbury, CT 06708-1458 | 2006-12-22 |
| 1225079189 | Scott Eric Shaw | Physician Assistant | 3535 S I-35 E, Denton, TX 76210-6850 | 2006-06-09 |
| 1326037870 | Scott David Shaw | Family Medicine | 1100 Salem Ave, Dayton, OH 45406-5144 | 2005-10-18 |
| Street Address |
12 HEALTH SERVICES DR |
| City | DEKALB |
| State | IL |
| Zip Code | 60115-9637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144393497 | Amylynn M Weiten | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2006-11-16 |
| 1952900375 | Brianna Rae Johnson | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2020-10-19 |
| 1215543111 | Rhyann Brianna Locke | Social Worker | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2020-09-17 |
| 1952925182 | Mariah Anne Thompson | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2020-06-03 |
| 1376167734 | Hannah Grace Brennan | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2020-06-02 |
| 1619590981 | Samantha Nikole Gudmunson | Registered Nurse | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2020-05-21 |
| 1992326151 | Dianna Huttunen | Case Management | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2020-04-29 |
| 1558982702 | Kathleen C Wilkerson | Case Management | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2020-04-29 |
| 1457983108 | Andrew Ryan Phillips | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2020-02-11 |
| 1225670219 | Bonn Christian Cruz | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2019-10-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372179 | Megan Erhart | Counselor | 304 N. 6th Street, Dekalb, IL 60115 | 2020-09-28 |
| 1689141616 | Stephanie Klewin | Psychologist | 631 S 1st Street, Dekalb, IL 60115 | 2018-10-29 |
| 1164902219 | Kimberly Ann Hart | Counselor | 290 N. Annie Glidden Drive, Gh 416, Niu, Dekalb, IL 60115 | 2018-08-17 |
| 1497235824 | Cory David Michael Hayden | Specialist/Technologist | 175 Yordon Center (niu Athletic Training), Dekalb, IL 60115 | 2018-08-15 |
| 1154807808 | Michael John Borak | Pharmacist | 975 S Annie Glidden Road, Schnucks Market Inc, Dekalb, IL 60115 | 2018-07-16 |
| 1184125841 | Candace Schroeffel | Student in an Organized Health Care Education/Training Program | 520 Garden Rd, Dekalb, IL 60115 | 2018-02-27 |
| 1033627583 | Hannah M Studebaker | Massage Therapist | 3266 Sycamore Road, Dekalb, IL 60115 | 2018-01-18 |
| 1649700238 | Jennifer Mangino | Behavioral Analyst | 138 Berkshire Dr, Dekalb, IL 60115 | 2017-06-15 |
| 1003346628 | Victoria Tullock | Counselor | 631 South First St., Dekalb, IL 60115 | 2017-06-15 |
| 1194263848 | Brianna Kraft | Specialist/Technologist | 900 Crane Dr, Dekalb, IL 60115 | 2017-02-02 |
| Find all providers in zip 60115 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457983108 | Andrew Ryan Phillips | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2020-02-11 |
| 1760943492 | Harold Lynn Drake | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2019-03-26 |
| 1225545734 | Bernice E. Jarvis-anderson | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2018-01-05 |
| 1295259059 | Kristen Angela Melchiori | Counselor | 631 S 1st St, Dekalb, IL 60115-4117 | 2017-08-02 |
| 1679923437 | Paul Grasemann | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2016-06-13 |
| 1689032807 | Stephanie Maszczyk | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2016-02-02 |
| 1710363221 | Robin Waffle | Counselor | 330 Grove St, Dekalb, IL 60115-3703 | 2015-08-06 |
| 1437535929 | Melissa M Johnson | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2015-08-06 |
| 1457737132 | Bridget Kennedy | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2015-08-05 |
| 1639562101 | Marissa Kirch | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2015-03-09 |
| Find all providers in DEKALB | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.