Provider Demographics
NPI:1336126747
Name:SHAW, PATRICIA (LPC-S)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:SHAW
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 271792
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78427-1792
Mailing Address - Country:US
Mailing Address - Phone:512-577-2994
Mailing Address - Fax:737-255-8607
Practice Address - Street 1:2746 SAN ANTONIO AVE
Practice Address - Street 2:
Practice Address - City:INGLESIDE
Practice Address - State:TX
Practice Address - Zip Code:78362-5725
Practice Address - Country:US
Practice Address - Phone:512-577-2994
Practice Address - Fax:737-255-8607
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17672101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional