Individual provider Active NPI

Tiffany R Shaw, LCSW

  • Clinical Social Worker
  • Breaux Bridge, LA
National Provider Identifier
1326878307
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5141 Issued in LA
Practice address
3310 Daisy Meadows LN
Breaux Bridge, LA 70517-6978
Phone
(337) 351-7071
NPI assigned
Aug 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 5141 LA Primary
Clinical Social Worker 1041C0700X 14215719-3501 UT
Clinical Social Worker 1041C0700X 12228-C NV
Clinical Social Worker 1041C0700X 6501C AL

Addresses

Primary practice location

3310 Daisy Meadows LN
Breaux Bridge, LA 70517-6978

Mailing address

PO Box 84
Breaux Bridge, LA 70517-0084
Phone (337) 351-7071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20240926003636 LA Practitioner - Clinical Social Worker 9032640339 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5141LAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Azalea Health Services Clinical CurrentSince Sep 16, 2024 Accepting new patients
Azalea Health Services Texas LLC Clinical CurrentSince Sep 16, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1326878307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705170084",
            "telephone_number": "337-351-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 DAISY MEADOWS LN",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705176978",
            "telephone_number": "337-351-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "TIFFANY",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "5141",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "14215719-3501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "12228-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "6501C",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Breaux Bridge, LA

Sources for this page

Verify at the official NPI Registry.