Active NPI
Wellington (Tony) Wilbert Shaw, PHD, NCP, CAPP, CART
- Mental Health Counselor
- Apopka, FL
National Provider Identifier
1659608909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CAPP-320, NCP-01277
- Practice address
- 3872 Long Branch Lane
Apopka, FL 32712-4790 - Phone
- (407) 880-8916
- Fax
- (407) 880-8916
- NPI assigned
- Nov 6, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CAPP-320, NCP-01277 | FL | Primary |
Addresses
Primary practice location
3872 Long Branch Lane
Apopka, FL 32712-4790
Mailing address
3872 Long Branch LN
Apopka, FL 32712-4790
Phone (407) 880-8916
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 904489719 | Other | FL | UNITED HEALTH CARE |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CAPP-320, NCP-01277 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257465600000",
"number": "1659608909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3872 LONG BRANCH LN",
"city": "APOPKA",
"state": "FL",
"postal_code": "327124790",
"telephone_number": "407-880-8916",
"fax_number": "407-880-8916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3872 LONG BRANCH LANE",
"city": "APOPKA",
"state": "FL",
"postal_code": "327124790",
"telephone_number": "407-880-8916",
"fax_number": "407-880-8916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "WELLINGTON (TONY)",
"middle_name": "WILBERT",
"name_prefix": "Dr.",
"credential": "PHD, NCP, CAPP, CART",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-11-06",
"last_updated": "2009-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "CAPP-320, NCP-01277",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "904489719",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Apopka, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.