Provider Demographics
NPI:1508160151
Name:EVANS, SHELLY RENEE (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:SHELLY
Middle Name:RENEE
Last Name:EVANS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8955 HIGHWAY 6 N
Mailing Address - Street 2:SUITE 150
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2320
Mailing Address - Country:US
Mailing Address - Phone:281-855-1982
Mailing Address - Fax:281-864-4353
Practice Address - Street 1:2542 RYAN ST
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-5883
Practice Address - Country:US
Practice Address - Phone:281-855-1982
Practice Address - Fax:281-864-4353
Is Sole Proprietor?:No
Enumeration Date:2010-12-22
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18960101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional