Individual provider · Type 1 NPI

Jayda Keyerra Blount Shaw, LCPC

Professional Counselor · Truckee, CA

NPI number 1891349148 Active

Practice location

10775 Pioneer Trl Ste 215
Truckee, CA 96161-0234

Call (415) 424-4266 Map

Fax (415) 520-6633

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XADT1995 (MD)
Professional Counselor Primary 101YP2500XLC12586 (MD)

Professional Counselor: Definition to come...

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About NPI 1891349148

Jayda Keyerra Blount Shaw, LCPC's National Provider Identifier is 1891349148, issued on Jul 25, 2019. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Truckee, CA. The record was last updated on Nov 6, 2022.