Provider Demographics
NPI:1457425027
Name:SHIRA, ERIKA ROSE (MA MT BC LMHC)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:ROSE
Last Name:SHIRA
Suffix:
Gender:F
Credentials:MA MT BC LMHC
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:ROSE
Other - Last Name:MCLAUGHLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA MT BC LMHC
Mailing Address - Street 1:22 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02119
Mailing Address - Country:US
Mailing Address - Phone:617-650-1810
Mailing Address - Fax:
Practice Address - Street 1:22 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02119-1522
Practice Address - Country:US
Practice Address - Phone:617-650-1810
Practice Address - Fax:888-972-4096
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
06943225A00000X
MA5803101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist