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Individual

JESSICA LYNN SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
PO BOX 741, MUSKEGO, WI 53150-0741
(262) 221-0369
Mailing address
PO BOX 741, MUSKEGO, WI 53150-0741
(262) 221-0369

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6502-125
WI
101YP2500X
Professional Counselor
Primary
6502-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100092725
WI
Enumeration date
02/22/2013
Last updated
01/28/2026
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