Provider Demographics
NPI:1922118736
Name:WOLBRINK, SHIRLEY LORRAINE (MS, LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:LORRAINE
Last Name:WOLBRINK
Suffix:
Gender:F
Credentials:MS, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 EVERHART RD
Mailing Address - Street 2:SUITE H21
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1926
Mailing Address - Country:US
Mailing Address - Phone:361-225-2763
Mailing Address - Fax:361-991-0085
Practice Address - Street 1:700 EVERHART RD
Practice Address - Street 2:SUITE H21
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1926
Practice Address - Country:US
Practice Address - Phone:361-225-2763
Practice Address - Fax:361-991-0085
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9494 AND 3224101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3169LCOtherBCBS
TX128747OtherMHN