Beverly Shaw Mack, LBSW

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

11758 Issued in TX

Practice address

6300 Hillcroft St Ste 200
Houston, TX 77081-3005

Phone

(281) 460-9590

Fax

(713) 278-9711

NPI assigned

Jun 9, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Integrity Healthcare Supports

  • Case Management Agency
  • Houston, TX
  • NPI 1700170081
  NPD (past)
• Integrity Medical Supply Etc

  dba Inner Door Counseling & Rehabilitation Center

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1962548602
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1003101817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5631 HERON DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770333131",
            "telephone_number": "281-460-9590",
            "fax_number": "713-278-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 HILLCROFT ST STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770813005",
            "telephone_number": "281-460-9590",
            "fax_number": "713-278-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "BEVERLY",
        "middle_name": "SHAW",
        "name_prefix": "Miss",
        "credential": "LBSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-09",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": "11758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Macinerney, M.ED., NCC, LPC
• Brittnee M Macintyre, MSN, APRN, FNP-C
• Susan Frank Macivor
• Mack Counseling PLLC
• Mack Counseling Residential
• Breonna Mack
• David Ross Mack, M.D.
• Dmonica Leflore Mack, LMSW
• Evangeline Mack, R.PH.
• Gardner Mack, MSN, APRN, FNP-C

• Case Manager/Care Coordinator in Houston, TX
• Providers in Houston, TX by specialty
• Case Manager/Care Coordinator in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.