Provider Demographics
NPI:1760800197
Name:JONES, SHYRA NICHELLE (LPC)
Entity Type:Individual
Prefix:MISS
First Name:SHYRA
Middle Name:NICHELLE
Last Name:JONES
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 1:4708 JOHN DAVID
Mailing Address - Street 2:APT. B
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549
Mailing Address - Country:US
Mailing Address - Phone:254-681-6702
Mailing Address - Fax:888-349-1644
Practice Address - Street 1:4708 JOHN DAVID DR
Practice Address - Street 2:APT. B
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-2664
Practice Address - Country:US
Practice Address - Phone:254-681-6702
Practice Address - Fax:888-349-1644
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66025101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor