Shaw, Tia D

Shaw, Tia D is an individual health care provider with primary practice located at 24 Sweden St Suite 201, Caribou ME 04736-2127. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Shaw, Tia D can be contacted via phone (207) 493-3366.

Contact Information

Primary practice address
24 Sweden St Suite 201 Caribou ME 04736-2127
Phone: (207) 493-3366
Fax: (207) 492-4889
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1346674124
LBN Legal business name Shaw, Tia D
Credentials BHP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2013
Last updated Aug 20th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346674124 NPPES
Maine MEDICAID 1346674124

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