Lake Erie Behavioral Health, LLC

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD458004 Issued in PA

Legal business name

LAKE ERIE BEHAVIORAL HEALTH, LLC

Practice address

3216 State St
Erie, PA 16508

Phone

(814) 812-2633

NPI assigned

Oct 27, 2017

Last updated

Nov 17, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sherifia Elaine Heron, MDNPI 1023375250

Title

Ceo

Phone

(814) 454-3192

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sherifia Elaine Heron, M.D.

  • Psychiatry Physician
  • Erie, PA
  • NPI 1023375250
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1509062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605571200000",
    "number": "1245742469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082822",
            "telephone_number": "814-454-3192",
            "fax_number": "814-454-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "16508",
            "telephone_number": "814-812-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE ERIE BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-27",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "HERON",
        "authorized_official_first_name": "SHERIFIA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-454-3192",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD458004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamie Ann Laih, LSW
• Monica Laird, CRNP
• Stephanie Elaine Lajohn, CRNA
• Lake Effect Hearing LLC (Beltone Hearing Center)
• Lake Erie Anesthesia of PA LLC
• Lake Erie College of Osteopathic Medicine
• Lake Erie College of Osteopathic Medicine, Inc.
• Lake Erie Counseling Inc
• Lake Erie Dental, Inc.
• Lake Erie Home Health Agency LLC

• Child & Adolescent Psychiatry Physician in Erie, PA
• Providers in Erie, PA by specialty
• Child & Adolescent Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.