Bethany A Shaw Psychological Services, Ltd | |
107 E College Ave Ste 101 Westerville OH 43081-1613 | |
(614) 794-3138 | |
(614) 794-3175 |
Full Name | Bethany A Shaw Psychological Services, Ltd |
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Speciality | Psychologist |
Location | 107 E College Ave Ste 101, Westerville, Ohio |
Authorized Official Name and Position | Bethany Ann Shaw (CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 6147943138 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bethany A Shaw Psychological Services, Ltd 107 E College Ave Ste 101 Westerville OH 43081-1613 Ph: (614) 794-3138 | Bethany A Shaw Psychological Services, Ltd 107 E College Ave Ste 101 Westerville OH 43081-1613 Ph: (614) 794-3138 |
NPI Number | 1396977286 |
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Provider Enumeration Date | 08/11/2009 |
Last Update Date | 08/23/2023 |
Certification Date | 08/23/2023 |
Medicare PECOS PAC ID | 7719032754 |
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Medicare Enrollment ID | O20090827000370 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396977286 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | 5212 (Ohio) | Primary |
Provider Name | Bethany A Shaw |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1154489276 PECOS PAC ID: 5294880233 Enrollment ID: I20090827000336 |
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