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JACOB R SHAW
NPI 1396513719
Peer Specialist in Basin, WY

Active since December 14, 2023
116 SOUTH 3RD STREET, BASIN, WY 82410(307) 568-2020 Get Directions Write a Review

NPPES record last updated: December 14, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jacob R Shaw NPPES

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

JACOB R SHAW (NPI 1396513719) is an individual peer specialist in Basin, Wyoming, licensed in Wyoming (143) and active in the NPI registry since December 2023.

NPPES Registry Identity

NPI1396513719
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameJACOB R SHAW
Location Address116 SOUTH 3RD STREETBasin, WY 82410
Mailing Address1114 Lane 12Lovell, WY 82431-9555 · (307) 548-6543
Phone(307) 568-2020
Sole ProprietorNo
Enumeration DateDecember 14, 2023
NPPES CertifiedDecember 13, 2023
✔ NPI 1396513719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in WY · 143
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
116 SOUTH 3RD STREET, Basin, WY 82410
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Other Providers at the Same Location NPPES 2

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

DR. RALPH HENRY LOUIS JR. PH.D.
Psychologist (Clinical)
116 SOUTH 3RD STREET
BASIN, WY 82410
Big Horn County (307) 568-2020
ABBY BOWERS CMHW
Counselor
116 SOUTH 3RD STREET
BASIN, WY 82410
Big Horn County (307) 548-6543

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Shaw's NPI number?

The NPI number for Jacob Shaw is 1396513719. It was assigned to this individual provider in the NPPES registry on December 14, 2023.

Where is Jacob Shaw located?

Jacob Shaw practices at 116 South 3rd Street, Basin, WY 82410. The listed phone number is (307) 568-2020.

What is Jacob Shaw's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Jacob Shaw was last updated on December 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.