Healthcare Provider Details

I. General information

NPI: 1609611995
Provider Name (Legal Business Name): ERIN SHEA CAREY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 03/01/2026
Certification Date: 03/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 VICTORIA HILLS DR
DELAND FL
32724-8825
US

IV. Provider business mailing address

509 VICTORIA HILLS DR
DELAND FL
32724-8825
US

V. Phone/Fax

Practice location:
  • Phone: 570-898-0058
  • Fax:
Mailing address:
  • Phone: 570-898-0058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-86501
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-354758
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: