Mira B Shore, PSYD.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

850 N 11TH St
Philadelphia, PA 19123-1957

Phone

(267) 597-3604

NPI assigned

Apr 25, 2023

Last updated

Feb 12, 2026By 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

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Clinical Psychologist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Moore Psychological Services LLCGroup PAC ID 0648415646, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Moore Psychological Services, LLC

  • Clinical Psychologist
  • Springfield, PA
  • NPI 1164769543
  Medicare reassignment Care Compare group NPD
• Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1043204811
  Medicare reassignment NPD
• Resources for Human Development, Inc.

  dba LMCMS Peer Support

  • Community/Behavioral Health Agency
  • Bryn Mawr, PA
  • NPI 1548395585
  Medicare reassignment NPD
• Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1508748369
  NPD
• Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1689357782
  NPD
• Resources for Human Development, Inc.

  dba East Side Health Center

  • Federally Qualified Health Center (FQHC)
  • York, PA
  • NPI 1306127634
  NPD (past)

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1750079067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 CHESTER PIKE",
            "city": "SHARON HILL",
            "state": "PA",
            "postal_code": "190791411",
            "telephone_number": "610-639-0795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 N 11TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231957",
            "telephone_number": "267-597-3604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 Chester Pike",
            "address_purpose": "LOCATION",
            "city": "Sharon Hill",
            "state": "PA",
            "postal_code": "190791411",
            "country_code": "US",
            "telephone_number": "610-583-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHORE",
        "first_name": "MIRA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PSYD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefanie S Shopa, PA-C
• Glenn Shopper, MD
• Blake Shore
• Eric Eugene Shore, D.O.
• Jessica Nicole Shore, PSY.D.
• Nicole Shore
• Paul Michael Shore, MD
• Djuan Deshonge Short, LCSW
• Meg Short, PHARMD
• William R Short, MD

• Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.