Provider Demographics
NPI:1619359619
Name:KAMHOLZ, SHONDA (LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:SHONDA
Middle Name:
Last Name:KAMHOLZ
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 HAYMARKET LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-2543
Mailing Address - Country:US
Mailing Address - Phone:713-724-0789
Mailing Address - Fax:
Practice Address - Street 1:5715 LAVENDER ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026-1725
Practice Address - Country:US
Practice Address - Phone:832-314-4593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11532101YA0400X
TX77373101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)