Individual provider Active NPI

Renee D Shaw, LPC

  • Professional Counselor
  • Taylor, MI
National Provider Identifier
1699809194
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401005504 Issued in MI
Practice address
20500 Eureka Rd Ste 200
Taylor, MI 48180-6394
Phone
(517) 882-3732
Fax
(517) 882-3633
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401005504 MI Primary

Addresses

Primary practice location

20500 Eureka Rd Ste 200
Taylor, MI 48180-6394

Mailing address

20500 Eureka Rd Ste 200
Taylor, MI 48180-6394
Phone (517) 882-3732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231128002851 MI Practitioner - Mental Health Counselor 5890031728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

3200 Greenfield Rd
Suite 109
Dearborn, MI 48120-1802
Phone (517) 492-0517

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC Professional CurrentSince Jan 1, 2024 Accepting new patients
Downriver Mental Health Clinic PC CurrentSince Jan 1, 2024 Accepting new patients

Locations

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

20500 Eureka Rd
Ste 200
Taylor, MI 48180
Phone (734) 285-8282

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.reneeshaw@150339.advancedmd-direct.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1699809194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20500 EUREKA RD STE 200",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481806394",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20500 EUREKA RD STE 200",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481806394",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "RENEE",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401005504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

Verify at the official NPI Registry.