Provider Demographics
NPI:1376372144
Name:MEJIA, SHAROL KASSANDRA (LPC)
Entity type:Individual
Prefix:
First Name:SHAROL
Middle Name:KASSANDRA
Last Name:MEJIA
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 1:8331 FREDERICKSBURG RD STE 1604
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3339
Mailing Address - Country:US
Mailing Address - Phone:210-858-6127
Mailing Address - Fax:
Practice Address - Street 1:8331 FREDERICKSBURG RD STE 1604
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3339
Practice Address - Country:US
Practice Address - Phone:210-858-6127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85006101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional