Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Elyssa Lorraine Shaw, ASW11761

Individual provider Mental Health Counselor · NPI 1821800111

Elyssa Lorraine Shaw, ASW11761 is a Mental Health Counselor in Grand Terrace, California. Licensed in California. Registered with an NPI since 2025.

Licensed in
CA
In the registry since
2025
Specialties on file
2

Practice location Address checks out

21810 Main St
Grand Terrace, CA 92313-5810
Phone: (909) 580-5006
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence ASW11761
Mental Health Counselor Taxonomy 101YM0800X · Licence ASW11761 (CA)

Record details

NPI number1821800111
Entity typeIndividual (Type 1)
GenderFemale
Credentials ASW11761
Sole proprietorNo
NPI enumeratedJanuary 23, 2025
Last updated in NPPESJanuary 23, 2025
Certification dateJanuary 23, 2025

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