Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1962068650 Individual Practitioner Female Practitioner

Kelly Grace Shaw , MS, LPC, NCC

Counselor • Eugene, OR

Professional Overview & Biography Verified Profile Summary

Kelly Shaw, MS, LPC, NCC is a registered healthcare professional specializing in Counselor in Eugene, OR. Practice services are available at 770 E 11TH AVE FL SSB2 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

770 E 11th Ave Fl Ssb2

Eugene, OR 974013746

Telephone 4582057085
Fax 4582057089

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Eugene, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.1 Yrs
State Avg: 12.6 Yrs
Regional Practice Density
534 Specialists

Practicing in Eugene, OR (4551 Statewide)

Telehealth Adoption Rate
0.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-11-14
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Secondary Practice Locations

175 W B St

Springfield, OR 974774575

Phone: 5417621971

54771 Mckenzie Hwy

Blue River, OR 974139790

Phone: 5417711017

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

21 Associated Practitioners
Bridget Jenkins

Peer Specialist

NPI 1104284900
Suzanne Nielsen

Counselor - Mental Health

NPI 1124649660
Yesenia Farr

Counselor - Professional

NPI 1134632920
Shirley Spencer , MA, QMHP

Counselor - Professional

NPI 1306397666

Master of Arts, Qualified Mental Health Professional

NPI 1326521196

Licensed Social Worker

Jennifer Place

Peer Specialist

NPI 1336653237

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location November 14, 2023

Registered at 770 E 11TH AVE FL SSB2, EUGENE, OR 974013746 (Tel: 4582057085)

📍
Updated Practice Location May 05, 2022

Registered at 54771 MCKENZIE HWY, BLUE RIVER, OR 974139790 (Tel: 5417711017)

👤
Provider Name / Credentials Updated May 05, 2022

Recorded as KELLY SHAW, MS, LPC, NCC

NPI Profile Active May 17, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location May 17, 2019

Registered at 175 W B ST, SPRINGFIELD, OR 974774575 (Tel: 5417621971)

📍
Updated Business Mailing Address May 17, 2019

Registered at PO BOX 18, VIDA, OR 974880018 (Tel: 5417711017)

👤
Provider Name / Credentials Updated May 17, 2019

Recorded as KELLY ANTHONY, MS, QMHP, NCC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 17, 2019

Counselor

🟢
Initial NPI Registration & Enumeration May 17, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1962068650
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 17, 2019
Last Update: November 14, 2023
Sole Proprietor: No

Mailing Address

Po Box 18

Vida, OR 974880018

Phone: 5417711017

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.