KEVIN B SHAW (LCP) – Clinical Psychologist, NPI 1639193105

KEVIN B SHAW (LCP) is a healthcare provider. based in Ottawa, Kansas. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LCP. They hold a License No. 137 (KS). The NPI Number for KEVIN B SHAW (LCP) is 1639193105

Main info

Male
Sole Proprietor
38 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN B SHAW (LCP)
NPI
1639193105
Phone
(785) 242-8059
Address
1953 RENO RD
Enumeration Date
27 July 2006
Last Update Date
2 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7852422991
Graduation Year
1988 (38 years ago)
PAC ID
1557701661
Professional Enrollment ID
I20240801001315
Address ID
KS660672212OT109XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience71
Completeness75
Years active:19State licenses:2Digital endpointsOther names

387 MENTAL HEALTH COUNSELOR in KS

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Provider Addresses for KEVIN B SHAW (LCP)

  • 1953 RENO RD

    OTTAWA, KS 660678754

    Phone: (785) 242-8059

    Type: Mailing

  • 109, West 2nd Street, Delphos, Ottawa County, Kansas, 67436, United States

    OTTAWA, KS 660672212

    Phone: (785) 242-2991

    Fax: (785) 242-4401

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-08-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240801001315IMental Health CounselorKSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 66067)

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Reviews

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Frequently asked questions

What NPI should I save for KEVIN B SHAW (LCP)?
Save NPI 1639193105 if you need a stable reference for KEVIN B SHAW (LCP).
Is KEVIN B SHAW (LCP)'s NPI currently valid?
The extract we use shows KEVIN B SHAW (LCP) as active.
Can you summarize KEVIN B SHAW (LCP)'s specialty in plain language?
Clinically, the directory lists KEVIN B SHAW (LCP) with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where is KEVIN B SHAW (LCP)'s primary listing?
We display Ottawa, Kansas because that is what the record indicates for KEVIN B SHAW (LCP).
Is KEVIN B SHAW (LCP) a real provider?
This page reflects official NPPES data for NPI 1639193105. Always confirm identity and privileges with the practice and licensing boards.

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