Male or Other

Dr. Sidney L. Shaw LCPC

Professional Counselor in Missoula, MT(View on Map)

Full Name

Dr. Sidney L Shaw LCPC

NPI Number

1073689659

NPI Type

Individual Provider

Gender

Male

Enumeration Date

11/27/2006

Specialties

(Taxonomies)

Code

101YP2500X
101YM0800X

Primary Taxonomy

Yes
No

Licenses

State

Alaska
Montana

License Number

398
1456

Contact
Information

Purpose

Mailing
Location

Address

725 SW HIGGINS AVE STE B
725 SW HIGGINS AVE STE B

City

Missoula
Missoula

State

MT
MT

Postal Code

59803-1420
59803-1420

Country

US
US

Telephone Number

(406) 203-2150
(406) 203-2150

Identifiers

Identifier

CL3490

Identifier State

AK

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/04/2022

Provider Address

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