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Individual
STACEY F SHAW
Active
Individual
STACEY F SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
5751
FL
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP60832976
WA
1041C0700X
Clinical Social Worker
Primary
LW60832998
WA
1041C0700X
Clinical Social Worker
SW11562
FL
Other
Enumeration date
11/23/2013
Last updated
01/11/2025
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