Provider Demographics
NPI:1306181359
Name:HOFER, SHANNON LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:LYNN
Last Name:HOFER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 CHIMNEY WOOD CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-6730
Mailing Address - Country:US
Mailing Address - Phone:281-961-9079
Mailing Address - Fax:
Practice Address - Street 1:2006 CHIMNEY WOOD CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-6730
Practice Address - Country:US
Practice Address - Phone:281-961-9079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63459101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional