Provider Demographics
NPI:1194201806
Name:DAVIS SHADE, ERIKA ALLISON (MCMHC, LPC CANDIATE)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:ALLISON
Last Name:DAVIS SHADE
Suffix:
Gender:F
Credentials:MCMHC, LPC CANDIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 NE 122ND ST APT 1311
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-9210
Mailing Address - Country:US
Mailing Address - Phone:918-232-6791
Mailing Address - Fax:
Practice Address - Street 1:1613 SE 66TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73149-5203
Practice Address - Country:US
Practice Address - Phone:405-616-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101Y00000XBehavioral Health & Social Service ProvidersCounselor