Provider Demographics
NPI:1194468884
Name:MORALES-SHELDON, MAILICELYN (LCSW)
Entity Type:Individual
Prefix:
First Name:MAILICELYN
Middle Name:
Last Name:MORALES-SHELDON
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:PO BOX 20712
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77225-0712
Mailing Address - Country:US
Mailing Address - Phone:956-251-0963
Mailing Address - Fax:
Practice Address - Street 1:4450 HARRISBURG BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77011-4014
Practice Address - Country:US
Practice Address - Phone:346-354-7628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX664381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical