Provider Demographics
NPI:1093707994
Name:SHEHORN, CARRI L (MED LPC)
Entity Type:Individual
Prefix:
First Name:CARRI
Middle Name:L
Last Name:SHEHORN
Suffix:
Gender:F
Credentials:MED LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 STEINBECK BEND DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76708-5204
Mailing Address - Country:US
Mailing Address - Phone:254-752-5900
Mailing Address - Fax:
Practice Address - Street 1:5201 STEINBECK BEND DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-5204
Practice Address - Country:US
Practice Address - Phone:254-752-5900
Practice Address - Fax:254-752-5901
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20269101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1803496Medicaid