MR. FRED THOMAS PAUL SHAH LCMHC LCASA NPI 1073857124

NPI Information

NPI: 1073857124
Provider Name: MR. FRED THOMAS PAUL SHAH, LCMHC, LCASA
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

PECOS Registration: Yes

Address:
610-A S. COLLEGE ROAD
WILMINGTON, NC
ZIP 28403
Phone: (910) 796-2490
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MR. Fred Thomas Paul Shah, LCMHC, LCASA is a professional counselor in Wilmington, NC. MR. Fred Thomas Paul Shah, LCMHC, LCASA NPI is 1073857124. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

610-A S. COLLEGE ROAD
WILMINGTON, NC
ZIP 28403-431
Phone: (910) 796-2490
Fax: (910) 202-9966

The NPI 1073857124 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 11/15/2012 and was last updated on 9/6/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	21403	NORTH CAROLINA	No
2	101YM0800X	Counselor	Mental Health	9687	NORTH CAROLINA	No
3	101YP2500X	Counselor	Professional	21403	NORTH CAROLINA	No
4	101YP2500X	Counselor	Professional	9687	NORTH CAROLINA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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