Active NPI
Annie Laverne Cummings Shaw, LPC
- Professional Counselor
- Raleigh, NC
National Provider Identifier
1912294893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 8621
- Practice address
- 3801 Computer Dr
Suite 112
Raleigh, NC 27609-6506 - Phone
- (919) 720-8461
- Fax
- (888) 235-4554
- NPI assigned
- Jun 29, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 8621 | NC | Primary |
Addresses
Primary practice location
3801 Computer Dr
Suite 112
Raleigh, NC 27609-6506
Mailing address
104 Emerald Glade CT
Garner, NC 27529-3771
Phone (919) 720-8461
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6104857 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8621 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425427200000",
"number": "1912294893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 EMERALD GLADE CT",
"city": "GARNER",
"state": "NC",
"postal_code": "275293771",
"telephone_number": "919-720-8461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 COMPUTER DR",
"address_2": "SUITE 112",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276096506",
"telephone_number": "919-720-8461",
"fax_number": "888-235-4554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "ANNIE",
"middle_name": "LAVERNE CUMMINGS",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-29",
"last_updated": "2015-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "8621",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6104857",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.