Individual
DR. SIDNEY L SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
725 SW HIGGINS AVE STE B, MISSOULA, MT 59803-1420
(406) 203-2150
Mailing address
725 SW HIGGINS AVE STE B, MISSOULA, MT 59803-1420
(406) 203-2150
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
398
AK
101YP2500X
Professional Counselor
Primary
1456
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CL3490
—
AK
Enumeration date
11/27/2006
Last updated
10/04/2022
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