Provider Demographics
NPI:1538916473
Name:BROWN, SHELBY (MA, LPC)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 E AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-2931
Mailing Address - Country:US
Mailing Address - Phone:662-316-4383
Mailing Address - Fax:
Practice Address - Street 1:1329 HIGHWAY 7E E
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-8918
Practice Address - Country:US
Practice Address - Phone:936-615-7927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87099101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health