Bethany Ann Shaw, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5212 Issued in OH

Practice address

167 S State St
Suite 100
Westerville, OH 43081-2265

Phone

(614) 794-3138

Fax

(614) 794-3175

NPI assigned

Dec 4, 2006

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

Other names 1

• Mrs. Bethany Ann Waluzak Former name

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bethany a Shaw Psychological Services, LTD

  • Clinical Psychologist
  • Westerville, OH
  • NPI 1396977286
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154489276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 S STATE ST",
            "address_2": "SUITE 100",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430812265",
            "telephone_number": "614-794-3138",
            "fax_number": "614-794-3175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 S STATE ST",
            "address_2": "SUITE 100",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430812265",
            "telephone_number": "614-794-3138",
            "fax_number": "614-794-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "BETHANY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "5212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "WALUZAK",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shellie Joi Shanklin
• Sebrina Shannon, BCBA/COBA
• Tarang Sharma, MD
• Jennifer Sharp, NP
• April Marie Shaw, RPH, PHARMD
• Anne Elizabeth Shea, LSW
• Jessica Sheahan
• Eileen H Sheets, MD
• Jennifer Sheets, LSW
• Gregory Jerome Shehee III

• Clinical Psychologist in Westerville, OH
• Providers in Westerville, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.