Stacey F Shaw, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60832998 Issued in WA

Practice address

3101 184TH St SW Unit D218
Lynnwood, WA 98037-4991

Phone

(425) 275-6681

NPI assigned

Nov 23, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Keep US Close LLC

  • Community/Behavioral Health Agency
  • Lynnwood, WA
  • NPI 1013727056
  NPD Authorized official
• Northpoint Washington LLC

  • Substance Abuse Rehabilitation Facility
  • Edmonds, WA
  • NPI 1891292900
  NPD (past)

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

{
    "created_epoch": "1385164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736553600000",
    "number": "1841620184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 184TH ST SW UNIT D218",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980374991",
            "telephone_number": "425-275-6681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 184TH ST SW UNIT D218",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980374991",
            "telephone_number": "425-275-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "STACEY",
        "middle_name": "F",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-23",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60832976",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "5751",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11562",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60832998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamrock Holdings LLC
• Andrew Gordon Shannahan, D.C.
• Julie Anne Sharif, MA LMHC
• Niyati Sharma
• Hillary Linwen Shaw, MD
• Amal Shawish
• Alhasan Maher Shebl
• Pamela Jeanne Sheehan, PTA
• Isak A Sheikabdilahi
• Galib Sheikh, LICSW

• Clinical Social Worker in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Clinical Social Worker in Washington

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