| Brian Shaw Psychotherapy, Llc | |
|
6910 Pacific St 320 Omaha NE 68106-1054 | |
| (402) 881-5475 | |
| Not Available |
| Full Name | Brian Shaw Psychotherapy, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6910 Pacific St, Omaha, Nebraska |
| Authorized Official Name and Position | Brian Kenneth Shaw (CLINICAL SOCIAL WORKER/OWNER) |
| Authorized Official Contact | 4028815475 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian Shaw Psychotherapy, Llc 6910 Pacific St 320 Omaha NE 68106-1054 Ph: (402) 881-5475 | Brian Shaw Psychotherapy, Llc 6910 Pacific St 320 Omaha NE 68106-1054 Ph: (402) 881-5475 |
| NPI Number | 1417497355 |
|---|---|
| Provider Enumeration Date | 02/26/2017 |
| Last Update Date | 02/26/2017 |
| Medicare PECOS PAC ID | 9133403041 |
|---|---|
| Medicare Enrollment ID | O20170221000900 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417497355 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 1142 2826 1275 (Nebraska) | Primary |
| Provider Name | Brian K Shaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255662508 PECOS PAC ID: 8123200797 Enrollment ID: I20140605001815 |
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