Provider Demographics
NPI:1194870022
Name:SHAW, MELISSA (LCSW)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:SHAW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 FLORIDA DRIVE
Mailing Address - Street 2:
Mailing Address - City:LOWER BURRELL
Mailing Address - State:PA
Mailing Address - Zip Code:15068-3333
Mailing Address - Country:US
Mailing Address - Phone:412-215-2485
Mailing Address - Fax:
Practice Address - Street 1:3 KENSINGTON SQ
Practice Address - Street 2:SUITE B
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6443
Practice Address - Country:US
Practice Address - Phone:724-335-9733
Practice Address - Fax:724-335-9734
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACWO146901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical