Individual
MR. JORDAN G SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
275 NORTHERN AVE, AUGUSTA, ME 04330-3928
(207) 402-4530
Mailing address
93 SILVER ST BLDG 6, WATERVILLE, ME 04901-5923
(207) 877-9435
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC7004
ME
Other
Enumeration date
09/25/2020
Last updated
07/19/2024
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