Provider Demographics
NPI:1376134494
Name:SHELLEY LITWAK COUNSELING PLLC
Entity Type:Organization
Organization Name:SHELLEY LITWAK COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LITWAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-235-8351
Mailing Address - Street 1:240 WOODCREST DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2037
Mailing Address - Country:US
Mailing Address - Phone:682-235-8351
Mailing Address - Fax:
Practice Address - Street 1:1755 N COLLINS BLVD STE 310
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3592
Practice Address - Country:US
Practice Address - Phone:682-235-8351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty