Provider Demographics
NPI:1295018521
Name:SHAW, CHRISTINA ROLAND (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ROLAND
Last Name:SHAW
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 CHATFIELD DR
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27282-9028
Mailing Address - Country:US
Mailing Address - Phone:336-309-3947
Mailing Address - Fax:
Practice Address - Street 1:960 CHATFIELD DR
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NC
Practice Address - Zip Code:27282-9028
Practice Address - Country:US
Practice Address - Phone:336-309-3947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0073821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical