Audrey Shaw, M.S.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC5017 Issued in ME

Practice address

16 Lincoln St
Brunswick, ME 04011-1900

Phone

(603) 883-0005

NPI assigned

Apr 1, 2014

Last updated

Jun 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Audrey Moore Former name

Medicare fee-for-service enrollment

Enrolled in ME

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

Credentials

Master of Science

State licenses

Practice roles

Locations

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

• Spurwink Services Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, ME
  • NPI 1760507297
  Medicare reassignment NPD
• The Counseling Center of Nashua Inc

  dba LifeStance Health

  • Clinical Psychologist
  • Nashua, NH
  • NPI 1144275389

  ME, Professional

  Medicare reassignment NPD
• Spurwink Services Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, ME
  • NPI 1316945090
  NPD (past)

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

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1790103224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 WORTHING RD",
            "city": "MANCHESTER",
            "state": "ME",
            "postal_code": "043513234",
            "telephone_number": "207-530-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 LINCOLN ST",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040111900",
            "telephone_number": "603-883-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "AUDREY",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-01",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ME",
            "license": "CC5017",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC5017",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "TN",
            "license": "000591828",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "MOORE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Select Physical Therapy Holdings, Inc. (Select Physical Therapy)
• Amy B. Sellers, LCSW
• Madelaine Miranda Sgroi, DO
• Virginia Leigh Shannon, LCPC-C
• Benjamin Howard Shapiro, MD
• Nirvana P. Shaw, LCSW
• Shaws Supermarkets Inc (Shaws Pharmacy #0628)
• Erin Sheets, PH.D.
• Amber Shepherd, FNP-BC
• Ingrid M Sherrill, PA

• Professional Counselor in Brunswick, ME
• Providers in Brunswick, ME by specialty
• Professional Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.