Provider Demographics
NPI:1043401482
Name:KEIPER-SHAW, AMY R (LCSW,QCSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:R
Last Name:KEIPER-SHAW
Suffix:
Gender:F
Credentials:LCSW,QCSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:R
Other - Last Name:SHAW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5 BUTTONWOOD CT
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1529
Mailing Address - Country:US
Mailing Address - Phone:267-364-0243
Mailing Address - Fax:
Practice Address - Street 1:5 BUTTONWOOD CT
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1529
Practice Address - Country:US
Practice Address - Phone:267-364-0243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0130791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical