Provider Demographics
NPI:1568227189
Name:PENN, SHEARON LARUE (LPC)
Entity Type:Individual
Prefix:
First Name:SHEARON
Middle Name:LARUE
Last Name:PENN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SHEARON
Other - Middle Name:L
Other - Last Name:PENN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:3939 W GREEN OAKS BLVD STE 214
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-2793
Mailing Address - Country:US
Mailing Address - Phone:469-490-1442
Mailing Address - Fax:
Practice Address - Street 1:3939 W GREEN OAKS BLVD STE 214
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-2793
Practice Address - Country:US
Practice Address - Phone:469-490-1442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89538101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty