Healthcare Provider Details

I. General information

NPI: 1457425027
Provider Name (Legal Business Name): ERIKA ROSE SHIRA MA MT BC LMHC
Entity Type: Individual
Gender:
Sole Proprietor: Y

Provider Other Name: ERIKA ROSE MCLAUGHLIN MA MT BC LMHC

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 HIGHLAND AVE
BOSTON MA
02119-1522
US

IV. Provider business mailing address

22 HIGHLAND AVE
BOSTON MA
02119
US

V. Phone/Fax

Practice location:
  • Phone: 617-650-1810
  • Fax: 888-972-4096
Mailing address:
  • Phone: 617-650-1810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number06943
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5803
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: