Active NPI
Kandi Denise Shaw, LPC
- Professional Counselor
- Waxahachie, TX
National Provider Identifier
1154553295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 63352
- Practice address
- 1014 Ferris Ave
Ste 2154
Waxahachie, TX 75165-2591 - Phone
- (254) 592-3385
- NPI assigned
- Aug 21, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 63352 | TX | Primary |
Addresses
Primary practice location
1014 Ferris Ave
Ste 2154
Waxahachie, TX 75165-2591
Mailing address
609 S Files St
Itasca, TX 76055-3001
Phone (254) 707-0058
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63352 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608681600000",
"number": "1154553295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "609 S FILES ST",
"city": "ITASCA",
"state": "TX",
"postal_code": "760553001",
"telephone_number": "254-707-0058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1014 FERRIS AVE",
"address_2": "STE 2154",
"city": "WAXAHACHIE",
"state": "TX",
"postal_code": "751652591",
"telephone_number": "254-592-3385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "KANDI",
"middle_name": "DENISE",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-21",
"last_updated": "2020-12-23",
"certification_date": "2020-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "63352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waxahachie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.