Susan L. Shaw, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C6447 Issued in MS

Practice address

1205 22ND Ave
Meridian, MS 39301-4010

Phone

(601) 483-2864

NPI assigned

Nov 18, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

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 Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Positive Innergy Counseling Services LLCGroup PAC ID 6204298367, 11 clinicians

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.

• Positive Innergy Counseling Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Meridian, MS
  • NPI 1003432626
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1225795859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12391 HIGHWAY 491 S",
            "city": "UNION",
            "state": "MS",
            "postal_code": "393658538",
            "telephone_number": "601-513-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 22ND AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014010",
            "telephone_number": "601-483-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "SUSAN",
        "middle_name": "L.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-18",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C6447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "familycounciling@comcast.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1205 22nd Ave",
            "city": "Meridian",
            "state": "MS",
            "country_code": "US",
            "postal_code": "393014010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Niraj James Shah, M.D
• Urooj Shahid, DO
• Shapiro Dimitri Medical, LLC
• Jayde Sharp, RN
• Christopher Robert Sharpe, PA-C
• Shelley W. McDonald, DMD, PA
• Shine Pediatric Psychology Services PLLC
• Shirley Home Care, LLC
• Ben J Shirley, CRNA
• Chelsea Hope Shirley

• Clinical Social Worker in Meridian, MS
• Providers in Meridian, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.