Provider Demographics
NPI:1497447585
Name:SCHELLENGER, CRYSHANNA
Entity Type:Individual
Prefix:
First Name:CRYSHANNA
Middle Name:
Last Name:SCHELLENGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1848 LONE STAR RD STE 125
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5791
Mailing Address - Country:US
Mailing Address - Phone:682-422-7070
Mailing Address - Fax:
Practice Address - Street 1:1848 LONE STAR RD STE 125
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-5791
Practice Address - Country:US
Practice Address - Phone:682-422-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84516101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional