Provider Demographics
NPI:1497462386
Name:DOYLE, SHELBY (LCSW)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 VINCA TRL
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77382-5753
Mailing Address - Country:US
Mailing Address - Phone:210-838-8661
Mailing Address - Fax:
Practice Address - Street 1:128 VISION PARK BLVD STE 230
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3018
Practice Address - Country:US
Practice Address - Phone:832-346-8082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX593221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical