Provider Demographics
NPI:1568018349
Name:SLD COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:SLD COUNSELING SERVICES, PLLC
Other - Org Name:SHANNON L DEITCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:DEITCH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:346-774-1774
Mailing Address - Street 1:105 N GORDON ST STE 202
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-2373
Mailing Address - Country:US
Mailing Address - Phone:346-774-1774
Mailing Address - Fax:
Practice Address - Street 1:105 N GORDON ST STE 202
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-2373
Practice Address - Country:US
Practice Address - Phone:346-774-1774
Practice Address - Fax:281-585-0080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-16
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty