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ALYSSA SHAW LPC
NPI 1003489279
Counselor - Mental Health in Springdale, AR

Active since July 23, 2021PECOS Enrolled
3623 JOHNSON MILL BLVD, SUITE 103, SPRINGDALE, AR 72762(479) 435-4207(479) 935-3180 Get Directions Write a Review

NPPES record last updated: October 27, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Alyssa Shaw Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALYSSA SHAW LPC (NPI 1003489279) is an individual mental health provider in Springdale, Arkansas, licensed in Arkansas (P2504006) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1003489279
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameALYSSA SHAWCredential: LPC
Location Address3623 JOHNSON MILL BLVD, SUITE 103Springdale, AR 72762-6412
Mailing AddressPo Box 9541Fayetteville, AR 72703-0026 · (479) 435-4207 · Fax (479) 935-3180
Phone(479) 435-4207
Fax(479) 935-3180
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJuly 23, 2021
Last NPPES UpdateOctober 27, 2025
NPPES CertifiedOctober 27, 2025
✔ NPI 1003489279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in AR · P2504006
3623 JOHNSON MILL BLVD, Springdale, AR 72762
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Other Identifiers 1

Medicaid272165795AR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Arkansas Blue Cross and Blue Shield, Health Advantage, Octave.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alyssa Shaw Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5092202788
PECOS Enrollment IDI20251015004877
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASHTYN MCCAIN
Counselor (Mental Health)
3623 JOHNSON MILL BLVD
SPRINGDALE, AR 72762
Washington County (479) 435-4207
YALAUNDA SANDIDGE LCSW
Social Worker (Clinical)
3623 JOHNSON MILL BLVD, SUITE 103
SPRINGDALE, AR 72762
Washington County (479) 435-4207
OLIVIA E DEAN LICENSED ASSOCIATE
Counselor (Mental Health)
3623 JOHNSON MILL BLVD, SUITE 103
SPRINGDALE, AR 72762
Washington County (497) 435-4207
ROXAN GONZALES
Counselor
3623 JOHNSON MILL BLVD
SPRINGDALE, AR 72762
Washington County (479) 435-4207
LUKE ALLEN
Social Worker
3623 JOHNSON MILL BLVD
SPRINGDALE, AR 72762
Washington County (479) 435-4207
ERICA REASER
Counselor
3623 JOHNSON MILL BLVD
SPRINGDALE, AR 72762
Washington County (479) 435-4207
ADRIANA DELPILAR LICENSED ASSOCIATE C
Counselor (Mental Health)
3623 JOHNSON MILL BLVD, SUITE 103
SPRINGDALE, AR 72762
Washington County (479) 435-4207
AMANDA N OSTERMAN LCSW
Social Worker (Clinical)
3623 JOHNSON MILL BLVD, SUITE 103
SPRINGDALE, AR 72762
Washington County (479) 435-4207

Frequently Asked Questions

What is Alyssa Shaw's NPI number?

The NPI number assigned to this healthcare provider is 1003489279, enumerated as an "individual" on July 23, 2021.

Where is the provider located?

The provider is located at 3623 JOHNSON MILL BLVD SUITE 103 SPRINGDALE, AR 72762 and the phone number is (479) 435-4207.

What is the provider's specialty?

Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

What insurance does Alyssa Shaw accept?

The provider might be accepting Accepts: Arkansas Blue Cross and Blue Shield, Health. Please consult your insurance carrier or call the provider to verify.