Provider Demographics
NPI:1518542208
Name:OKORO, SHAIUANA CARROLL (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHAIUANA
Middle Name:CARROLL
Last Name:OKORO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13215 AMBROSA DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-1543
Mailing Address - Country:US
Mailing Address - Phone:832-293-6034
Mailing Address - Fax:
Practice Address - Street 1:13215 AMBROSA DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-1543
Practice Address - Country:US
Practice Address - Phone:832-293-6034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-14
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79321101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX79321OtherNBCC