person
Dr. Jack William Shaw, EDD,LMHC
Mental Health Counselor in St Petersburg, Florida
NPI 1124623319

Jack William Shaw is a Mental Health Counselor based in Pinellas Park, FL and is specialized in Mental Health. Jack William Shaw practices in St Petersburg, FL and has the professional credentials of EDD,LMHC. The NPI Number for Jack William Shaw is 1124623319 and holds a License No. MCAP100243 (Florida).

The current practice location address for Jack William Shaw is 1735 Dr Mlk Jr Street South, St Petersburg, FL and can be reached out via phone at 727-502-0188.

Location: 1735 Dr Mlk Jr Street South, St Petersburg, FL, 33781-3440
person
Provider Profile Details
NPI Number
1124623319
Provider Name
Jack William Shaw
Credential
EDD,LMHC
Provider Entity Type
Individual
Gender
Male
Address
1735 Dr Mlk Jr Street South, St Petersburg, FL, 33781-3440
Phone Number
727-502-0188
Fax Number
Provider Enumeration Date
12/03/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1735 Dr Mlk Jr Street South
City
State
Zip
33705-2547
Phone Number
727-502-0188
Fax Number
person
Provider Business Mailing Address Details
Address
1735 Dr Mlk Jr Street South
City
State
Zip
33705-2547
Phone Number
727-502-0188
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
MH21197 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
MCAP100243 (Florida)
Definition
Definition to come...
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