Organization
BRIAN SHAW PSYCHOTHERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN KENNETH SHAW LICSW, LIMHP (CLINICAL SOCIAL WORKER/OWNER)
(402) 881-5475
Entity
Organization
Contact information
Practice address
6910 PACIFIC ST, 320, OMAHA, NE 68106-1054
(402) 881-5475
Mailing address
6910 PACIFIC ST, 320, OMAHA, NE 68106-1054
(402) 881-5475
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
1142 2826 1275
NE
Other
Enumeration date
02/26/2017
Last updated
02/26/2017
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