Provider Demographics
NPI:1568706729
Name:EVANS, SHELLEY DENISE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:DENISE
Last Name:EVANS
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 1:25752 KINGSLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2086
Mailing Address - Country:US
Mailing Address - Phone:281-392-7505
Mailing Address - Fax:281-392-7644
Practice Address - Street 1:25752 KINGSLAND BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2086
Practice Address - Country:US
Practice Address - Phone:281-392-7505
Practice Address - Fax:281-392-7644
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-12
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69980101YP2500X
AL1988101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional