Individual provider Active NPI

Jadie Marie Shaw, ALC

  • Mental Health Counselor
  • Enterprise, AL
National Provider Identifier
1417864471
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
ALC06153 Issued in AL
Practice address
805 E Lee St Ste C
Enterprise, AL 36330-2477
Phone
(334) 333-4940
NPI assigned
Aug 25, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ALC06153 AL Primary

Addresses

Primary practice location

805 E Lee St Ste C
Enterprise, AL 36330-2477

Mailing address

2394 County Road 13
Headland, AL 36345-8565
Phone (334) 333-4940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1417864471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2394 COUNTY ROAD 13",
            "city": "HEADLAND",
            "state": "AL",
            "postal_code": "363458565",
            "telephone_number": "334-333-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E LEE ST STE C",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302477",
            "telephone_number": "334-333-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JADIE",
        "middle_name": "MARIE",
        "credential": "ALC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-25",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "ALC06153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.