Active NPI
Elissa Lynn Shaw, LCSW
- Clinical Social Worker
- Austin, TX
National Provider Identifier
1194912121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 50393
- Practice address
- 5015 S Ih 35
Austin, TX 73301-2701 - Phone
- (512) 804-3220
- Fax
- (512) 326-1289
- NPI assigned
- Oct 3, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 50393 | TX | Primary |
Addresses
Primary practice location
5015 S Ih 35
Austin, TX 73301-2701
Mailing address
1430 Collier St
Austin, TX 78704-2911
Phone (512) 472-4357
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 |
|---|---|---|---|
| 50393 | TX | MD | Audiologist-Hearing Aid Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389139200000",
"number": "1194912121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1430 COLLIER ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787042911",
"telephone_number": "512-472-4357",
"fax_number": "512-703-1394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5015 S IH 35",
"city": "AUSTIN",
"state": "TX",
"postal_code": "733012701",
"telephone_number": "512-804-3220",
"fax_number": "512-326-1289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "ELISSA",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-03",
"last_updated": "2014-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "50393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; 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.