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NPI Code Detail

MEDICARE: MS. SHEERA ELAINE MAITLAND LPC

MEDICARE: MS. SHEERA ELAINE MAITLAND LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorPC005723PA

General Provider Information

NPI Number : 1083918627
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHEERA ELAINE MAITLAND LPC
Provider Business Mailing Address
First Line : 3854 TERRACE ST
Second Line : 3RD FLOOR
City : PHILADELPHIA
State : PA
Zip : 19128-5214
Country : US
Telephone Number : 609-513-1933
Fax Number :
Provider Business Practice Location Address
First Line : 3905 FORD RD
Second Line : SUITE 6
City : PHILADELPHIA
State : PA
Zip : 19131-2824
Country : US
Telephone Number : 215-220-2102
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2010
Last Update Date : 12/22/2010

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