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
Mailing address793 Sw Nautilus Rd, Lake City, FL 32024-1335

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