Active NPI
Wanda Shaw
- Addiction (Substance Use Disorder) Counselor
- Wichita, KS
National Provider Identifier
1770907438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 237
- Practice address
- 1319 W May St
Wichita, KS 67213-3505 - Phone
- (316) 262-0505
- Fax
- (316) 262-7384
- NPI assigned
- Feb 14, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 237 | KS | Primary |
Addresses
Primary practice location
1319 W May St
Wichita, KS 67213-3505
Mailing address
3932 N Amidon Ave
Wichita, KS 67204-3405
Phone (316) 262-0505
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 237 | KS | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392336000000",
"number": "1770907438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3932 N AMIDON AVE",
"city": "WICHITA",
"state": "KS",
"postal_code": "672043405",
"telephone_number": "316-262-0505",
"fax_number": "316-262-7384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1319 W MAY ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672133505",
"telephone_number": "316-262-0505",
"fax_number": "316-262-7384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "WANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-14",
"last_updated": "2014-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "KS",
"license": "237",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.