Provider Demographics
NPI:1235533712
Name:JONES-COLSON, SHANICA (MS, MHA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHANICA
Middle Name:
Last Name:JONES-COLSON
Suffix:
Gender:F
Credentials:MS, MHA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 N REILLY RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-5724
Mailing Address - Country:US
Mailing Address - Phone:910-879-6102
Mailing Address - Fax:
Practice Address - Street 1:1775 SAINT JAMES PL STE 325
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-3472
Practice Address - Country:US
Practice Address - Phone:832-780-3497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87449101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional