Crystal Shaw, LCMHC, CRC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10482 Issued in NC

Practice address

107 Pinecrest TRL
Rockingham, NC 28379-7429

Phone

(843) 277-8567

NPI assigned

Jun 23, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1972289122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 RIVERS AVE STE 370",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294065008",
            "telephone_number": "843-277-8567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 PINECREST TRL",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283797429",
            "telephone_number": "843-277-8567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "CRYSTAL",
        "name_prefix": "Miss",
        "credential": "LCMHC, CRC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "10482",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "10482",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "10482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sands Speech Services PLLC
• Jessica Sybil Sawyer Horne, CSW
• Alissa Marie Scott, MSW, LCSWA
• Jacob Austin Sedberry, PHARMD
• Parth Shah, DDS
• David J Shin, MD
• Shipman Family Home Care Inc
• John Edward Sikes, PHARMD
• Heather Bryce Simmons-Futrell
• Joel Thomas Simmons, PMHNP-BC, RN

• Mental Health Counselor in Rockingham, NC
• Providers in Rockingham, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.