Cynthia Shaw, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.010599 Issued in IL

Practice address

405 N Wabash Ave Unit 2511
Chicago, IL 60611-5668

Phone

(312) 505-8858

NPI assigned

Sep 16, 2021

Last updated

Sep 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 5, 2023 through Jul 5, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1598435984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N WABASH AVE UNIT 2511",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115668",
            "telephone_number": "312-505-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N WABASH AVE UNIT 2511",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115668",
            "telephone_number": "312-505-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "CYNTHIA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.010599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "071.010599",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DrCynthiaShaw@ResilienceChicago.com",
            "affiliation": "N",
            "address_1": "405 N Wabash Ave Unit 2511",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606115668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alison Shaw, APN
• Barbara Shaw, APN
• Barbara I Shaw, MSW, MHP
• Charles T Shaw, M.D.
• Csherica Shaw
• Donna J Shaw
• Frank Shaw, DDS
• Jack Ching Shaw, OPTICIAN
• Jason Shaw Jr., MA, LPC
• John M Shaw, MD

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.