Kelly Grace Shaw, MS, LPC, NCC
Counselor in Eugene, OR. Individual provider (NPI-1).
NPI number1962068650
StatusActive
Last updated in NPPESNov 14, 2023
Details
- NPI
- 1962068650
- Entity type
- Individual (NPI-1)
- Name
- Kelly Grace Shaw
- Credential
- MS, LPC, NCC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 17, 2019
- Certification date
- Nov 14, 2023
- Last updated
- Nov 14, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | OR | Yes |
Practice location
770 E 11th Ave Fl Ssb2Eugene, OR 97401-3746
Phone 458-205-7085 · Fax 458-205-7089
Mailing address
Po Box 18Vida, OR 97488-0018
Phone 541-771-1017
Other practice locations
54771 McKenzie Hwy
Blue River, OR 97413-9790
Blue River, OR 97413-9790
Phone 541-771-1017
175 W B St
Springfield, OR 97477-4575
Springfield, OR 97477-4575
Phone 541-762-1971
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