Provider Demographics
NPI:1538736723
Name:SAUL, SHANNON KATHRYN (LPC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:KATHRYN
Last Name:SAUL
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 1:1607 HATCH RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-5343
Mailing Address - Country:US
Mailing Address - Phone:512-496-5536
Mailing Address - Fax:
Practice Address - Street 1:1607 HATCH RD
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-5343
Practice Address - Country:US
Practice Address - Phone:512-496-5536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82271101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor