Jason Shaw Jr., MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.016637 Issued in IL

Practice address

2000 N Racine Ave Ste 3300
Chicago, IL 60614-4045

Phone

(312) 718-9464

NPI assigned

Dec 18, 2020

Last updated

Dec 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Abbie Kelley, LLC

  dba AMK Counseling

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1386048825
  NPD

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1790371227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3133 N HARDING AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N RACINE AVE STE 3300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144045",
            "telephone_number": "312-718-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JASON",
        "name_suffix": "Jr.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.016637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://amkcounseling.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2000 N Racine Ave Ste 3300",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606144045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Csherica Shaw
• Cynthia Shaw, PSYD
• Donna J Shaw
• Frank Shaw, DDS
• Jack Ching Shaw, OPTICIAN
• John M Shaw, MD
• Julia Renee Shaw
• Katie Shaw
• Matthew Q Shaw, MD
• Maurice Shaw

• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.