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Organization

SHAW FOUNDATION CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TONY SHAW PSYD, LCPC;LCADC (CEO)
(443) 629-5515
Entity
Organization

Contact information

Practice address
2814 W GARRISON AVE, BALTIMORE, MD 21215-5335
(443) 629-5515
Mailing address
2814 W GARRISON AVE, BALTIMORE, MD 21215-5335
(443) 629-5515

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
06/18/2025
Last updated
06/18/2025
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