Healthcare Provider Details

I. General information

NPI: 1659068476
Provider Name (Legal Business Name): SHIRA CHRISTINE HEARN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2023
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2830 MOUNT HOPE RD
WEBB CITY MO
64870-9674
US

IV. Provider business mailing address

2830 MOUNT HOPE RD
WEBB CITY MO
64870-9674
US

V. Phone/Fax

Practice location:
  • Phone: 417-768-9089
  • Fax:
Mailing address:
  • Phone: 417-768-9089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2022045023
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: