Provider Demographics
NPI:1376697763
Name:SHIELDS, ERIN KAY (MSSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:KAY
Last Name:SHIELDS
Suffix:
Gender:F
Credentials:MSSW LCSW
Other - Prefix:MRS
Other - First Name:ERIN
Other - Middle Name:KAY
Other - Last Name:MOSIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSSW
Mailing Address - Street 1:819 MT TABOR RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150
Mailing Address - Country:US
Mailing Address - Phone:812-948-9487
Mailing Address - Fax:812-948-9487
Practice Address - Street 1:819 MT TABOR RD
Practice Address - Street 2:SUITE 3
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150
Practice Address - Country:US
Practice Address - Phone:812-948-9487
Practice Address - Fax:812-948-9487
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN340026551041C0700X
KY8981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical