Brian Shaw Psychotherapy, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

1142 2826 1275 Issued in NE

Legal business name

BRIAN SHAW PSYCHOTHERAPY, LLC

Practice address

6910 Pacific St
320
Omaha, NE 68106-1054

Phone

(402) 881-5475

NPI assigned

Feb 26, 2017

Last updated

Feb 26, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brian Kenneth Shaw, LICSW, LIMHPNPI 1255662508

Title

Clinical Social Worker/Owner

Phone

(402) 881-5475

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian Kenneth Shaw, MSW, LCSW, LMHP

  • Mental Health Counselor
  • Omaha, NE
  • NPI 1255662508
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1488067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488067200000",
    "number": "1417497355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 PACIFIC ST",
            "address_2": "320",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681061054",
            "telephone_number": "402-881-5475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 PACIFIC ST",
            "address_2": "320",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681061054",
            "telephone_number": "402-881-5475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN SHAW PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-26",
        "last_updated": "2017-02-26",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER/OWNER",
        "authorized_official_telephone_number": "402-881-5475",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICSW, LIMHP"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NE",
            "license": "1142 2826 1275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Y Brewer
• Trinity Brewer
• Lindsey M Brezenski
• Brian F. Guenther DC PC
• Brian Schnieder
• Erik Brian
• Briana Black Health Services LLC
• Michaela Shannon Lord Briardy, OTR/L, LPN
• Francisca Bribiesca
• Yaqueline A Bribiesca

• Adult Mental Health Clinic/Center in Omaha, NE
• Providers in Omaha, NE by specialty
• Adult Mental Health Clinic/Center in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.