Provider Demographics
NPI:1144854050
Name:WESSELS, SHEILA R (MED, LPC, RPT)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:R
Last Name:WESSELS
Suffix:
Gender:F
Credentials:MED, LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11709 SHOSHONE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4225
Mailing Address - Country:US
Mailing Address - Phone:512-659-4355
Mailing Address - Fax:
Practice Address - Street 1:1213 W 49TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3102
Practice Address - Country:US
Practice Address - Phone:512-695-6453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-29
Last Update Date:2020-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68008101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional