Provider Demographics
NPI:1598231987
Name:YEAGER, D'SHWN CHRISTINE (LPC)
Entity Type:Individual
Prefix:MS
First Name:D'SHWN
Middle Name:CHRISTINE
Last Name:YEAGER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:D'SHAWN
Other - Middle Name:
Other - Last Name:MCCANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:4014 94TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-3930
Mailing Address - Country:US
Mailing Address - Phone:832-723-5906
Mailing Address - Fax:
Practice Address - Street 1:8302 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2835
Practice Address - Country:US
Practice Address - Phone:832-723-5906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-23
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80514101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1366651374Medicaid