Provider Demographics
NPI:1316564792
Name:KEITH, SHAWN (LPC)
Entity Type:Individual
Prefix:MS
First Name:SHAWN
Middle Name:
Last Name:KEITH
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 1:26411 OAK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1964
Mailing Address - Country:US
Mailing Address - Phone:281-352-9398
Mailing Address - Fax:
Practice Address - Street 1:26310 OAK RIDGE DR STE 12
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-3777
Practice Address - Country:US
Practice Address - Phone:281-352-9398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-01
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73045101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional