Provider Demographics
NPI:1629333430
Name:QUINTANILLA, SHAWN DENISE (LPC-S, LMFT)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:DENISE
Last Name:QUINTANILLA
Suffix:
Gender:F
Credentials:LPC-S, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 N PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-4216
Mailing Address - Country:US
Mailing Address - Phone:281-997-8400
Mailing Address - Fax:832-997-8408
Practice Address - Street 1:1506 BROADWAY ST
Practice Address - Street 2:SUITE 103
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5838
Practice Address - Country:US
Practice Address - Phone:832-303-3992
Practice Address - Fax:832-947-1117
Is Sole Proprietor?:No
Enumeration Date:2012-07-08
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65502101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional