Active NPI
Carrie Beth Shaw, LPC
- Professional Counselor
- Longview, TX
National Provider Identifier
1578780912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 16092
- Practice address
- 411 N Fredonia St Ste 114
Longview, TX 75601-6467 - Phone
- (903) 238-6924
- Fax
- (409) 877-1363
- NPI assigned
- Apr 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 16092 | TX | Primary |
Addresses
Primary practice location
411 N Fredonia St Ste 114
Longview, TX 75601-6467
Mailing address
PO Box 612
Judson, TX 75660-0612
Phone (903) 238-6924
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 177591801 | Medicaid | TX |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16092 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762214400000",
"number": "1578780912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 612",
"city": "JUDSON",
"state": "TX",
"postal_code": "756600612",
"telephone_number": "903-238-6924",
"fax_number": "409-877-1363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 N FREDONIA ST STE 114",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756016467",
"telephone_number": "903-238-6924",
"fax_number": "409-877-1363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "CARRIE",
"middle_name": "BETH",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2025-11-04",
"certification_date": "2025-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "16092",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "177591801",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.