Individual provider Active NPI

Aubrey Shaw

  • Mental Health Counselor
  • Medford, OR
National Provider Identifier
1881104057
Registry record updated Oct 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1175 E Main St Ste 1C
Medford, OR 97504-7457
Phone
(541) 772-0127
NPI assigned
Oct 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1175 E Main St Ste 1C
Medford, OR 97504-7457

Mailing address

715 SW Ramsey Ave
Grants Pass, OR 97527-5500
Phone (541) 944-3077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20241206003278 OR Practitioner - Clinical Social Worker 9739615246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portland DBT Institute IncGroup PAC ID 7911141742, 28 clinicians

Practice addresses (Care Compare)

5100 S Macadam Ave
Suite 350
Portland, OR 97239-3877
Phone (503) 231-7854

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Portland DBT Institute, Inc. CurrentSince Dec 2, 2024 Accepting new patients

Locations

7 Crater Lake Ave
Ste 7A
Medford, OR 97504

5200 S Macadam Ave
Ste 580
Portland, OR 97239
Phone (503) 231-7854

5100 S Macadam Ave
Ste 350
Portland, OR 97239
Phone (503) 231-7854

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506902400000",
    "number": "1881104057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 SW RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275500",
            "telephone_number": "541-944-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 E MAIN ST STE 1C",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047457",
            "telephone_number": "541-772-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "AUBREY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2017-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.