| Doctor Name: | MR. SIDNEY L SHAW |
| NPI Number: | 1073689659 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC CDCF |
| License Number: | 1456 |
| Business Practice Address: | 201 3rd Ave Suite 201 Seward, AK - 996642088 |
| Business Phone Number: | 9072243490 |
| Business Fax Number: | 9072245870 |
| Mailing Address: | 500 N Higgins Ave, Suite 109 MISSOULA |
| State: | MT |
| Postal Code: | 598024551 |
| Phone Number: | 4065462363 |
| Fax Number: | |
| NPI Enumeration Date: | 11/27/2006 |
| NPI Last Update Date: | 02/17/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 1456 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |