Provider Demographics
NPI:1356851273
Name:BERIS, SHEA LAREE (MFT, LPCC-S)
Entity Type:Individual
Prefix:MRS
First Name:SHEA
Middle Name:LAREE
Last Name:BERIS
Suffix:
Gender:F
Credentials:MFT, LPCC-S
Other - Prefix:MS
Other - First Name:SHEA
Other - Middle Name:LAREE
Other - Last Name:MCCREERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT, LPC
Mailing Address - Street 1:180 HIGH ST STE D
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-1874
Mailing Address - Country:US
Mailing Address - Phone:330-331-9203
Mailing Address - Fax:234-200-0584
Practice Address - Street 1:180 HIGH ST STE D
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-1874
Practice Address - Country:US
Practice Address - Phone:330-331-9203
Practice Address - Fax:234-200-0584
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1901283-SUPV101YP2500X
OHM1700020106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist