Active NPI
Dareece Shaw
- Marriage & Family Therapist
- Defuniak Springs, FL
National Provider Identifier
1598059453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MT3080
- Practice address
- 3686 US Highway 331 S
Defuniak Springs, FL 32435-8463 - Phone
- (850) 892-8045
- Fax
- (850) 892-8039
- NPI assigned
- Jun 7, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MT3080 | FL | Primary |
Addresses
Primary practice location
3686 US Highway 331 S
Defuniak Springs, FL 32435-8463
Mailing address
3686 US Highway 331 S
Defuniak Springs, FL 32435-8463
Phone (850) 892-8045
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT3080 | FL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444608000000",
"number": "1598059453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3686 US HIGHWAY 331 S",
"city": "DEFUNIAK SPRINGS",
"state": "FL",
"postal_code": "324358463",
"telephone_number": "850-892-8045",
"fax_number": "850-892-8039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3686 US HIGHWAY 331 S",
"city": "DEFUNIAK SPRINGS",
"state": "FL",
"postal_code": "324358463",
"telephone_number": "850-892-8045",
"fax_number": "850-892-8039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "DAREECE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-07",
"last_updated": "2015-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "MT3080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Defuniak Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.