Shea Laree Beris, MFT, LPCC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.1901283-SUPV Issued in OH

Practice address

180 High St Ste D
Wadsworth, OH 44281-1874

Phone

(330) 331-9203

Fax

(234) 200-0584

NPI assigned

Oct 5, 2017

Last updated

Mar 25, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Shea Laree McCreery Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Serenity Family and Individual Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wadsworth, OH
  • NPI 1417506965

  Professional

  NPD Authorized official

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

{
    "created_epoch": "1507161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1356851273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HIGH ST STE D",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442811874",
            "telephone_number": "330-331-9203",
            "fax_number": "234-200-0584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 HIGH ST STE D",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442811874",
            "telephone_number": "330-331-9203",
            "fax_number": "234-200-0584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERIS",
        "first_name": "SHEA",
        "middle_name": "LAREE",
        "name_prefix": "Mrs.",
        "credential": "MFT, LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-05",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1901283-SUPV",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "M1700020",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "1(234)200-0584",
            "affiliation": "N",
            "endpointDescription": "Fax",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PDF",
            "address_1": "180 High St Ste D",
            "city": "Wadsworth",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442811874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHEA",
            "last_name": "MCCREERY",
            "middle_name": "LAREE",
            "prefix": "MS.",
            "credential": "MFT, LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Kaitlin M Bierman
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• Reid Black

• Professional Counselor in Wadsworth, OH
• Providers in Wadsworth, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; 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.