Provider Demographics
NPI:1669832275
Name:ERICKSON-ABOU ZAHR, SHAUNA (MS LMFT)
Entity Type:Individual
Prefix:MS
First Name:SHAUNA
Middle Name:
Last Name:ERICKSON-ABOU ZAHR
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:SHAUNA
Other - Middle Name:
Other - Last Name:ERICKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1201 25TH ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-2311
Mailing Address - Country:US
Mailing Address - Phone:701-451-4900
Mailing Address - Fax:
Practice Address - Street 1:815 37TH AVE S
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-5524
Practice Address - Country:US
Practice Address - Phone:701-451-4811
Practice Address - Fax:651-925-0057
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2016-053106H00000X
MN3486106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist