Active NPI
Tia D Shaw, BHP
- Mental Health Counselor
- Caribou, ME
National Provider Identifier
1346674124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 24 Sweden St
Suite 201
Caribou, ME 04736-2127 - Phone
- (207) 493-3366
- Fax
- (207) 492-4889
- NPI assigned
- Aug 28, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
24 Sweden St
Suite 201
Caribou, ME 04736-2127
Mailing address
24 Sweden St
Suite 201
Caribou, ME 04736-2127
Phone (207) 493-3366
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346674124 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408492800000",
"number": "1346674124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 SWEDEN ST",
"address_2": "SUITE 201",
"city": "CARIBOU",
"state": "ME",
"postal_code": "047362127",
"telephone_number": "207-493-3366",
"fax_number": "207-492-4889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 SWEDEN ST",
"address_2": "SUITE 201",
"city": "CARIBOU",
"state": "ME",
"postal_code": "047362127",
"telephone_number": "207-493-3366",
"fax_number": "207-492-4889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "TIA",
"middle_name": "D",
"credential": "BHP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-28",
"last_updated": "2014-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1346674124",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Caribou, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.