DR. MIRA B SHORE PSYD. NPI 1750079067

NPI Information

  • NPI: 1750079067
  • Provider Name: DR. MIRA B SHORE, PSYD.
  • Classification: Counselor - 101Y00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 850 N 11TH ST
    PHILADELPHIA, PA
    ZIP 19123
  • Phone: (267) 597-3604

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NPI Details

DR. Mira B Shore, PSYD. is a counselor in Philadelphia, PA with 4 years of experience. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. DR. Mira B Shore, PSYD. NPI is 1750079067. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

850 N 11TH ST
PHILADELPHIA, PA
ZIP 19123-957
Phone: (267) 597-3604

The NPI 1750079067 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 4/25/2023 and was last updated on 10/7/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103T00000XPsychologistNo
2101Y00000XCounselorYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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