Provider Demographics
NPI:1093428526
Name:VALERIE SHAW COUNSELING, LLC
Entity Type:Organization
Organization Name:VALERIE SHAW COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-481-7473
Mailing Address - Street 1:31 E CAROLINA AVE APT 308
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-4550
Mailing Address - Country:US
Mailing Address - Phone:901-481-7473
Mailing Address - Fax:
Practice Address - Street 1:31 E CAROLINA AVE APT 308
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-4550
Practice Address - Country:US
Practice Address - Phone:901-481-7473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-29
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty