MEDICARE: DR. ERICA SHAWN MERSON PH.D.

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
1	103TC1900X	Counseling Psychologist	PSY1000940	DC

General Provider Information

NPI Number	:	1285143172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERICA SHAWN MERSON PH.D.

Provider Business Mailing Address
First Line	:	5426 MACARTHUR BLVD NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20016-2524
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1555 CONNECTICUT AVE NW STE 300
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20036-1125
Country	:	US
Telephone Number	:	973-979-5005
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2017
Last Update Date	:	09/24/2017

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