Active NPI
Jeremiah Lawrence Shaw
- Mental Health Counselor
- San Diego, CA
National Provider Identifier
1457542870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2155 Felspar St
Apt 1
San Diego, CA 92109-3624 - Phone
- (646) 251-2486
- NPI assigned
- Aug 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2155 Felspar St
Apt 1
San Diego, CA 92109-3624
Mailing address
2155 Felspar St
Apt 1
San Diego, CA 92109-3624
Phone (646) 251-2486
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": "1186617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186617600000",
"number": "1457542870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2155 FELSPAR ST",
"address_2": "APT 1",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921093624",
"telephone_number": "646-251-2486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2155 FELSPAR ST",
"address_2": "APT 1",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921093624",
"telephone_number": "646-251-2486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "JEREMIAH",
"middle_name": "LAWRENCE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-09",
"last_updated": "2007-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.