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Frrederick Gardiner Shaw, MS,LCPC
Mental Health Counselor in Avon, Illinois
NPI 1770652224

Frrederick Gardiner Shaw is a Mental Health Counselor based in Cobden, IL and is specialized in Mental Health. Frrederick Gardiner Shaw practices in Avon, IL and has the professional credentials of MS,LCPC. The NPI Number for Frrederick Gardiner Shaw is 1770652224 and holds a License No. (Illinois).

The current practice location address for Frrederick Gardiner Shaw is 6655 E. Us 36, Avon, IL and can be reached out via phone at 317-272-3330.

Location: 6655 E. Us 36, Avon, IL, 62920-3223
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Provider Profile Details
NPI Number
1770652224
Provider Name
Frrederick Gardiner Shaw
Credential
MS,LCPC
Provider Entity Type
Individual
Gender
Male
Address
6655 E. Us 36, Avon, IL, 62920-3223
Phone Number
317-272-3330
Fax Number
Provider Enumeration Date
11/07/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
9132002 01 IL BLUE CROSS BLUE SHIELD
073120 01 IL HEALTH ALLIANCE
institution
Provider Business Practice Location Address Details
Address
6655 E. Us 36
City
State
Zip
46123
Phone Number
317-272-3330
Fax Number
person
Provider Business Mailing Address Details
Address
6655 E. Us 36
City
State
Zip
46123
Phone Number
317-272-3330
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
(Illinois)
Definition
Definition to come...
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