Provider Demographics
NPI:1477933000
Name:SHIRLEY, ERICA L (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:L
Last Name:SHIRLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 TH & O STS NW
Mailing Address - Street 2:1 DARNALL HALL
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20057-1238
Mailing Address - Country:US
Mailing Address - Phone:202-687-7080
Mailing Address - Fax:
Practice Address - Street 1:37 TH & O STS NW
Practice Address - Street 2:1 DARNALL HALL
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20057-1238
Practice Address - Country:US
Practice Address - Phone:202-687-7080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-09
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1000993103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical