Scott D. Shaw, D.MIN.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401007864 Issued in MI

Practice address

3501 Lake Eastbrook Blvd SE
Suite 280
Grand Rapids, MI 49546-5938

Phone

(616) 942-7331

Fax

(616) 942-8807

NPI assigned

Jan 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1801945324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 LAKE EASTBROOK BLVD SE",
            "address_2": "SUITE 280",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465938",
            "telephone_number": "616-942-7331",
            "fax_number": "616-942-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 LAKE EASTBROOK BLVD SE",
            "address_2": "SUITE 280",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465938",
            "telephone_number": "616-942-7331",
            "fax_number": "616-942-8807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "SCOTT",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.MIN.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401007864",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801081490",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Noelle Shaw, PA-C
• Jordan T Shaw, M.D.
• Kylie M Shaw
• Mitchell Shaw, RD
• Raven Shaw, BEHAVIOR TECHNICIAN
• Thomas R Shaw, MD
• Shawn L. Gauthier
• Carla Shay
• Cheri Rose Shay
• Tyler Shear, ATC

• Professional Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.