Individual
AMELIA JEAN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSSW, LCSW
Contact information
Practice address
1201 BROAD ROCK BLVD MEDICAL CENTER 652/122 SOCIAL WORK, RICHMOND, VA 23249-2305
(804) 675-5000
Mailing address
3200 WINCHESTER ST, HENRICO, VA 23231-2347
(937) 546-3619
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
0009922206
CO
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
0904013671
VA
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
03/25/2019
Last updated
03/03/2025
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