Proud Mental Health LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PROUD MENTAL HEALTH LLC

Practice address

1309 Coffeen Ave # 19118
Sheridan, WY 82801-5777

Phone

(657) 229-5479

NPI assigned

Mar 9, 2026

Organization subpart

No

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

Authorized official

Name

Jonathan Wayne Shaw, PMHNPNPI 1023641743

Title

Owner/Ceo

Phone

(657) 229-5479

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jonathan Shaw, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Eugene, OR
  • NPI 1023641743
  NPD Authorized official

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

{
    "created_epoch": "1773014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773014400000",
    "number": "1093661241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 COFFEEN AVE # 19118",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828015777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 COFFEEN AVE # 19118",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828015777",
            "telephone_number": "657-229-5479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROUD MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-09",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "657-229-5479",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Sheridan, WY
• Providers in Sheridan, WY by specialty
• Mental Health Counselor in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; 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.