Provider Demographics
NPI:1598097297
Name:JAMES, SHEREDA KAY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHEREDA
Middle Name:KAY
Last Name:JAMES
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 1:711 WEST 38TH STREET, SUITE E-2
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1132
Mailing Address - Country:US
Mailing Address - Phone:512-451-2186
Mailing Address - Fax:
Practice Address - Street 1:711 W 38TH ST STE E2
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1132
Practice Address - Country:US
Practice Address - Phone:512-451-2186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16605101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX741200136OtherBLUE CROSS BLUE SHIELD