Christina Marie Shaw, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.0004161 Issued in OH

Practice address

38882 Mentor Ave
Willoughby, OH 44094-7875

Phone

(440) 953-9999

Fax

(440) 918-3839

NPI assigned

May 18, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Christina Marie Fowler Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Signature Health, Inc.

  • Mental Health Counselor
  • Garfield Heights, OH
  • NPI 1679767289
  Medicare reassignment NPD
• Signature Health Inc

  • Long Term Care Pharmacy
  • Willoughby, OH
  • NPI 1740502335
  NPD

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1972950087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38882 MENTOR AVE.",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "44094",
            "telephone_number": "440-953-9999",
            "fax_number": "440-918-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38882 MENTOR AVE",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440947875",
            "telephone_number": "440-953-9999",
            "fax_number": "440-918-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2022-01-10",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.0004161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "FOWLER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margaret Ann Senskey
• Teymour Sepahbodi, MD
• Seva Dental Ohio II LLC
• Seva Dental Ohio LLC
• Karrie A Shannon, PT
• Jill Press Shemory, COTA/L
• Kristina Olegovna Shkolnik, PHARM.D.
• Perry Shockey, RN
• Travis Richard Shrout
• Amanda Shuluga-Strogin

• Mental Health Counselor in Willoughby, OH
• Providers in Willoughby, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.