Tony C Shaw, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC11938 Issued in MD

Practice address

102 6TH Ave NE Ste B
Glen Burnie, MD 21060-6869

Phone

(410) 352-7514

NPI assigned

Aug 20, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Tony Shaw Professional name

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Shaw Foundation Corporation

  • Mental Health Counselor
  • Baltimore, MD
  • NPI 1346137825
  NPD Authorized official
• RRRS Each One Teach One Healthcare Services LLC

  dba RRRS Each One Teach One Healthcare Services

  • Addiction (Substance Use Disorder) Counselor
  • Baltimore, MD
  • NPI 1386375301
  NPD (past) Authorized official
• KP Counseling Services, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Baltimore, MD
  • NPI 1871067603
  NPD (past)

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1730791609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2814 W GARRISON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155335",
            "telephone_number": "443-629-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 6TH AVE NE STE B",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210606869",
            "telephone_number": "410-352-7514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2814 W Garrison Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212155335",
            "country_code": "US",
            "telephone_number": "443-629-5155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3202 Spaulding Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212155811",
            "country_code": "US",
            "telephone_number": "443-629-5515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "TONY",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-20",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "LC11938",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC11938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONY",
            "last_name": "SHAW",
            "prefix": "MR.",
            "credential": "LCPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jamilah Malak Shakir-Reese, MD
• Bhavana Sharma, M.D.
• Sabita Sharma, M.D.
• Susheel K Sharma, M.D.
• Dominique Sharps, LPN
• Kathleen Sheahon, MD
• Elizabeth Snyder Shearer, DNP, CRNP, AGNP-C
• Laura Christine Sheely, CRNP
• Jenna Blair Sheffield
• Kristilee P Sheffler, LGSW

• Mental Health Counselor in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.