Provider Demographics
NPI:1154627685
Name:ENDLEY, SHUBHRA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHUBHRA
Middle Name:
Last Name:ENDLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 W 14TH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-4114
Mailing Address - Country:US
Mailing Address - Phone:713-802-0545
Mailing Address - Fax:713-802-1225
Practice Address - Street 1:520 W 14TH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-4114
Practice Address - Country:US
Practice Address - Phone:713-802-0545
Practice Address - Fax:713-802-1225
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX339571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical