Provider Demographics
NPI:1043938236
Name:HANLEY, SHELLEY (MS, LPC-A)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:
Last Name:HANLEY
Suffix:
Gender:F
Credentials:MS, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 CAMELLIA DR
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-4519
Mailing Address - Country:US
Mailing Address - Phone:512-800-0057
Mailing Address - Fax:
Practice Address - Street 1:130 CAMELLIA DR
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-4519
Practice Address - Country:US
Practice Address - Phone:512-846-3199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89527101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty