Provider Demographics
NPI:1235910886
Name:SHUTT, MOLLY J (LPC)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:J
Last Name:SHUTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 LONGMIRE RD
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-1819
Mailing Address - Country:US
Mailing Address - Phone:936-443-9629
Mailing Address - Fax:855-443-9630
Practice Address - Street 1:620 LONGMIRE RD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-1819
Practice Address - Country:US
Practice Address - Phone:936-443-9629
Practice Address - Fax:855-443-9630
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional