Individual provider · Type 1 NPI
Marlisa Monae Shaw
Professional Counselor · New Haven, CT
NPI number
1053104802
Active
Practice location
458 Grand Ave
New Haven, CT 06513-3856
Mailing address
151 Putnam St
New Haven, CT 06519-2329
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 8405 (CT) |
Professional Counselor: Definition to come...
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About NPI 1053104802
Marlisa Monae Shaw's National Provider Identifier is 1053104802, issued on May 26, 2025. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in New Haven, CT. The record was last updated on May 26, 2025.