Provider Demographics
NPI:1609611995
Name:CAREY, ERIN SHEA
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:SHEA
Last Name:CAREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3128 BENT TREE LN
Mailing Address - Street 2:
Mailing Address - City:TOANO
Mailing Address - State:VA
Mailing Address - Zip Code:23168-9625
Mailing Address - Country:US
Mailing Address - Phone:570-898-0058
Mailing Address - Fax:
Practice Address - Street 1:7143 STONEWALL PKWY
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-1158
Practice Address - Country:US
Practice Address - Phone:570-898-0058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VARBT-24-354758106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician