Provider Demographics
NPI:1649915208
Name:THOMAS, SHAMBRA (MA, LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:SHAMBRA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MA, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11211 KATY FWY STE 510
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-2124
Mailing Address - Country:US
Mailing Address - Phone:346-704-1458
Mailing Address - Fax:
Practice Address - Street 1:11211 KATY FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2126
Practice Address - Country:US
Practice Address - Phone:346-704-1458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88269101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional