Provider Demographics
NPI:1437264108
Name:FRISBIE, SHAUNA (EDD LPC)
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:
Last Name:FRISBIE
Suffix:
Gender:F
Credentials:EDD LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5212 75TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2520
Mailing Address - Country:US
Mailing Address - Phone:806-781-5143
Mailing Address - Fax:806-698-8710
Practice Address - Street 1:5212 75TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2520
Practice Address - Country:US
Practice Address - Phone:806-781-5143
Practice Address - Fax:806-698-8710
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16714101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10773361OtherCAQH
TX4066LCOtherBLUE CROSS BLUE SHIELD