Provider Demographics
NPI:1346785292
Name:MARION, SHAKINAH (LPC)
Entity Type:Individual
Prefix:MISS
First Name:SHAKINAH
Middle Name:
Last Name:MARION
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 1:6209 TANZANITE DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-3360
Mailing Address - Country:US
Mailing Address - Phone:254-458-3696
Mailing Address - Fax:
Practice Address - Street 1:6209 TANZANITE DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-3360
Practice Address - Country:US
Practice Address - Phone:254-458-3696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-02
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71683101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health