Provider Demographics
NPI:1225108616
Name:SHAW, LORI ANN (LSCSW)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:SHAW
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:MR
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:WEAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1730 BELMONT
Mailing Address - Street 2:PO BOX 258
Mailing Address - City:PARSONS
Mailing Address - State:KS
Mailing Address - Zip Code:67357-0258
Mailing Address - Country:US
Mailing Address - Phone:620-421-3770
Mailing Address - Fax:620-421-0665
Practice Address - Street 1:1730 BELMONT
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:KS
Practice Address - Zip Code:67357-0258
Practice Address - Country:US
Practice Address - Phone:620-421-3770
Practice Address - Fax:620-421-0665
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2382104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS207967OtherGREAT WEST HEALTH PARTNER
VA564220OtherVALUE OPTION INC
KS070628OtherBLUE CROSS BLUE SHIELD
KS070628Medicare UPIN