Provider Demographics
NPI:1366105975
Name:SHAW, CHRISTINE A (LPC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:SHAW
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 BISHOP HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQ
Mailing Address - State:PA
Mailing Address - Zip Code:19073-3211
Mailing Address - Country:US
Mailing Address - Phone:610-995-2800
Mailing Address - Fax:
Practice Address - Street 1:31 BISHOP HOLLOW RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQ
Practice Address - State:PA
Practice Address - Zip Code:19073-3211
Practice Address - Country:US
Practice Address - Phone:610-550-6424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011289101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty