Individual provider · Type 1 NPI

Sha'leda Mirra

Clinical Social Worker · Lake City, FL

NPI number 1780015214 Active

Practice location

922 SW Baya Dr
Lake City, FL 32025-4209

Call (386) 697-8115 Map

Mailing address

793 SW Nautilus Rd
Lake City, FL 32024-1335

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X5724 (FL)
Clinical Social Worker Primary 1041C0700XSW11702 (FL)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1780015214

Sha'leda Mirra's National Provider Identifier is 1780015214, issued on Dec 10, 2013. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Lake City, FL. The record was last updated on Dec 10, 2013.