Provider Demographics
NPI:1750453031
Name:WEBSTER, SHIRLEY A (MFT, LADC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:A
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:MFT, LADC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3275 LAKE SHORE DR
Mailing Address - Street 2:
Mailing Address - City:WASHOE VALLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89704-9249
Mailing Address - Country:US
Mailing Address - Phone:775-849-3434
Mailing Address - Fax:775-849-3435
Practice Address - Street 1:3275 LAKESHORE DRIVE
Practice Address - Street 2:HTN
Practice Address - City:WASHOE VALLEY
Practice Address - State:NV
Practice Address - Zip Code:89704
Practice Address - Country:US
Practice Address - Phone:775-849-3434
Practice Address - Fax:775-849-3435
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK137101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health