Provider Demographics
NPI:1922535376
Name:SHAW, ELIZABETH HELEN (LMHC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HELEN
Last Name:SHAW
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 WARREN ST W
Mailing Address - Street 2:
Mailing Address - City:RAYNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02767-1314
Mailing Address - Country:US
Mailing Address - Phone:508-688-5987
Mailing Address - Fax:
Practice Address - Street 1:200 CHAUNCY ST STE 113
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-1200
Practice Address - Country:US
Practice Address - Phone:508-388-1479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-16
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10000232101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health