Shay E Dam-Erickson, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

67966 Issued in TX

Practice address

4703 Gonzales Street
Austin, TX 78702

Phone

(512) 264-4942

NPI assigned

Aug 28, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Shay Erickson Professional name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Brightside Medical, P.C.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1801355482

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1679358733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 RESEARCH BLVD STE 160C",
            "address_2": "PMB 1510",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595718",
            "telephone_number": "512-264-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4703 GONZALES STREET",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78702",
            "telephone_number": "512-264-4942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAM-ERICKSON",
        "first_name": "SHAY",
        "middle_name": "E",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "67966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAY",
            "last_name": "ERICKSON",
            "credential": "MA, LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Leslie W Dalton III, MD
• Mark Ray Dalton, M.D.
• Sodonya Dalton
• Tristanne Dalton, SLP
• Sholana Day Daly
• Diana Elaine Damer, PH.D.
• Susan Dametz
• Faith Damico, CF-SLP
• Diane Damitio
• Eswar Keran Chandra Damodara, BDS., MS

• Professional Counselor in Austin, TX
• Providers in Austin, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.