Provider Demographics
NPI:1376380535
Name:SHANGREAUX, ELOIS MARIE (LPC)
Entity type:Individual
Prefix:
First Name:ELOIS
Middle Name:MARIE
Last Name:SHANGREAUX
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 1:2927 PERSHING DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-2419
Mailing Address - Country:US
Mailing Address - Phone:915-543-8448
Mailing Address - Fax:
Practice Address - Street 1:2927 PERSHING DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-2419
Practice Address - Country:US
Practice Address - Phone:915-543-8448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-13
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90225101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor