Jordan G Shaw, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC7004 Issued in ME

Practice address

275 Northern Ave
Augusta, ME 04330-3928

Phone

(207) 402-4530

NPI assigned

Sep 25, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1427665231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 SILVER ST BLDG 6",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015923",
            "telephone_number": "207-877-9435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 NORTHERN AVE",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043303928",
            "telephone_number": "207-402-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JORDAN",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-25",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "CC7004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marjan S Seywerd, D.D.S.
• Rabia Shamim, DMD
• Tennie Margaret Shardlow, PA-C
• Amit Kumar Sharma, MD
• Crista Anne Shaw, LCPC
• Michelle Marie Shaw, LCSW
• Shaws Supermarkets Inc
• Alam Sher, PHARMD
• Karen Sherlock, RN
• Rattanaporn Sherman, RRT

• Mental Health Counselor in Augusta, ME
• Providers in Augusta, ME by specialty
• Mental Health Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.