Provider Demographics
NPI:1871262246
Name:SHEA, ERIN KATHLEEN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:KATHLEEN
Last Name:SHEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 ACCOMACK DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-2016
Mailing Address - Country:US
Mailing Address - Phone:024-193-4485
Mailing Address - Fax:
Practice Address - Street 1:4301 ACCOMACK DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2016
Practice Address - Country:US
Practice Address - Phone:502-419-3448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical