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KELLY GRACE SHAW
NPI 1780231100
Social Worker - Clinical in Crownsville, MD

Active since August 21, 2019PECOS Enrolled
757 WHITNEYS LANDING DR, CROWNSVILLE, MD 21032(443) 420-8073 Get Directions Write a Review

NPPES record last updated: April 2, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 2, 2025, Sep 28, 2024, Apr 13, 2020 and 1 more (4 updates tracked since 2019).

About Kelly Grace Shaw NPPES

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

KELLY GRACE SHAW (NPI 1780231100) is an individual clinical provider in Crownsville, Maryland, licensed in Maryland (27718) and active in the NPI registry since August 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780231100
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKELLY GRACE SHAW
Location Address757 WHITNEYS LANDING DRCrownsville, MD 21032-1113
Mailing Address757 Whitneys Landing DrCrownsville, MD 21032-1113 · (443) 789-4440
Phone(443) 420-8073
Sole ProprietorYes
Enumeration DateAugust 21, 2019
Last NPPES UpdateApril 2, 20254 updates tracked since enumeration
NPPES CertifiedApril 2, 2025
✔ NPI 1780231100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MD · 27718
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
757 WHITNEYS LANDING DR, Crownsville, MD 21032
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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.

Medicare Billing Reassignment

Medicare enrollment records show Kelly Shaw reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mental Health Specialty Group PA
247 mi
Mental Health
110 N CORCORAN ST FL 5
Durham, NC 27701
  • Reassigned Medicare billing, Maryland enrollment
  • 71 clinicians in this Medicare group
NPI 1801472634 (323) 205-7088

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21032 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $60.73 – $183.44
Typical copayment $0.00 (range $15.18 – $45.86)
Most-billed visit code NA
Established Patient
$75.47 typical visit price
range $19.60 – $149.17
Typical copayment $18.86 (range $4.90 – $37.29)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Kelly Shaw's NPI number?

The NPI number for Kelly Shaw is 1780231100. It was assigned to this individual provider in the NPPES registry on August 21, 2019.

Where is Kelly Shaw located?

Kelly Shaw practices at 757 Whitneys Landing Dr, Crownsville, MD 21032. The listed phone number is (443) 420-8073.

What is Kelly Shaw's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kelly Shaw enrolled in Medicare?

Yes. Kelly Shaw is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kelly Shaw's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Shaw reassigns Medicare benefits to Mental Health Specialty Group PA (Durham, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Shaw's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kelly Shaw was last updated on April 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.