Andrew Michael Shaw, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

14945 Issued in NC

Practice address

4030 Wake Forest Rd Ste 349
Raleigh, NC 27609-0010

Phone

(919) 436-1817

Fax

(919) 578-5025

NPI assigned

May 21, 2019

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

Opted out of Medicare

Yes, effective Dec 15, 2023 through Dec 15, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Andrew Shaw Counseling and Consulting, PLLC

  • Mental Health Counselor
  • Raleigh, NC
  • NPI 1144962507
  NPD Authorized official

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1548827975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 770",
            "address_2": "4801 GLENWOOD AVE STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 WAKE FOREST RD STE 349",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276090010",
            "telephone_number": "919-436-1817",
            "fax_number": "919-578-5025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ANDREW",
        "middle_name": "MICHAEL",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "U",
        "enumeration_date": "2019-05-21",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "14945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jireh S Sharpless
• Lauren Sharpless, PT, DPT
• Amie Lynn Sharrits, M.D.
• Daniel Watkins Shattuck, PH.D., LCMHC
• Joseph Tillman Shaughnessy, DC
• Annie Laverne Cummings Shaw, LPC
• Danielle Shaw
• Kim Shaw
• Leslie S Shaw, NP
• Lori Shaw

• Mental Health Counselor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.