Active NPI
Shaw Mindful Medicine PLLC
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Philadelphia, PA
National Provider Identifier
1679430326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Legal business name
- SHAW MINDFUL MEDICINE PLLC
- Doing business as
- TrueMynd Psychiatry
- Practice address
- 701 E Cathedral Rd Ste 45
Philadelphia, PA 19128-2128 - Phone
- (917) 575-5662
- Fax
- (844) 739-1051
- NPI assigned
- Jan 6, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Justin William Shaw, NP-P, PMHNP-BC
- Title
- Owner
- Phone
- (917) 575-5662
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Primary |
Addresses
Primary practice location
701 E Cathedral Rd Ste 45
Philadelphia, PA 19128-2128
Mailing address
606 Green Meadow Dr
Douglassville, PA 19518-1344
Phone (917) 575-5662
Other names 1
- TrueMynd Psychiatry
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Long Island City, NY
- NPI 1932611357
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1767657600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1767657600000",
"number": "1679430326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "606 GREEN MEADOW DR",
"city": "DOUGLASSVILLE",
"state": "PA",
"postal_code": "195181344",
"telephone_number": "917-575-5662",
"fax_number": "844-739-1051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 E CATHEDRAL RD STE 45",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191282128",
"telephone_number": "917-575-5662",
"fax_number": "844-739-1051"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHAW MINDFUL MEDICINE PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-01-06",
"last_updated": "2026-01-06",
"certification_date": "2026-01-06",
"status": "A",
"authorized_official_last_name": "SHAW",
"authorized_official_first_name": "JUSTIN",
"authorized_official_middle_name": "WILLIAM",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "917-575-5662",
"authorized_official_credential": "NP-P, PMHNP-BC"
},
"taxonomies": [
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "TrueMynd Psychiatry",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.