Provider Demographics
NPI:1902794332
Name:HOLLAND, SHANDRA (LPC-A)
Entity type:Individual
Prefix:
First Name:SHANDRA
Middle Name:
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 CHILDRESS DR
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-5180
Mailing Address - Country:US
Mailing Address - Phone:469-630-4341
Mailing Address - Fax:
Practice Address - Street 1:2379 GUS THOMASSON RD STE 300
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-7102
Practice Address - Country:US
Practice Address - Phone:972-882-6344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX98341101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional