Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sha'leda Mirra

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1780015214

Sha'leda Mirra is a Clinical Social Worker in Lake City, Florida. Qualified in 2011, 15 years ago. Practices with Optum Behavioral Care of North Carolina PC, a 176-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
15
Licensed in
FL
In the registry since
2013
Specialties on file
2
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Practice location Address checks out

922 SW Baya Dr
Lake City, FL 32025-4209
Phone: (386) 697-8115
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence SW11702 (FL)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 5724 (FL)

Record details

NPI number1780015214
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 10, 2013
Last updated in NPPESDecember 10, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Optum Behavioral Care Of North Carolina Pc — 176 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Lake City