Individual provider Active NPI

Deloris Lajoy Shaw, LPC

  • Professional Counselor
  • Suffolk, VA
National Provider Identifier
1548974256
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701012106 Issued in VA
Practice address
7025 Harbour View Blvd
Suffolk, VA 23435-2761
Phone
(757) 758-5106
NPI assigned
Jan 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701012106 VA Primary

Addresses

Primary practice location

7025 Harbour View Blvd
Suffolk, VA 23435-2761

Mailing address

908 Ellington SQ
Portsmouth, VA 23701-3948
Phone (757) 663-3858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241023000054 VA Practitioner - Mental Health Counselor 2668905175 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701012106VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Suffolk Psychotherapy, Inc. Professional CurrentSince Sep 13, 2024 Accepting new patients
Western Tidewater Community Mental CurrentSince Feb 14, 2025 Accepting new patients

Locations

200 E 2nd Ave
Franklin, VA 23851
Phone (757) 562-2208

1801 S Church St
Ste 6
Smithfield, VA 23430

1913 S Church St
Ste 2
Smithfield, VA 23430
Phone (757) 357-7458

7025 Harbour View Blvd
Ste 119
Suffolk, VA 23435
Phone (757) 670-7471

114 N Main St
Ste 102
Suffolk, VA 23434
Phone (757) 809-5376

5268 Godwin Blvd
Suffolk, VA 23434
Phone (757) 255-7117

135 S Saratoga St
Suffolk, VA 23434
Phone (757) 925-1981

1000 Commercial Ln
Suffolk, VA 23434
Phone (757) 925-2484

425 W Washington St
Ste 4
Suffolk, VA 23434
Phone (757) 209-4607

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1548974256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 ELLINGTON SQ",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237013948",
            "telephone_number": "757-663-3858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7025 HARBOUR VIEW BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352761",
            "telephone_number": "757-758-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "DELORIS",
        "middle_name": "LAJOY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701012106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.