Provider Demographics
NPI:1457122863
Name:SHELLEY J WHITE LPC PC
Entity Type:Organization
Organization Name:SHELLEY J WHITE LPC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:806-670-3757
Mailing Address - Street 1:PO BOX 19178
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79114-1178
Mailing Address - Country:US
Mailing Address - Phone:806-670-3757
Mailing Address - Fax:806-383-8789
Practice Address - Street 1:5410 BELL ST # B414
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-6222
Practice Address - Country:US
Practice Address - Phone:806-670-3755
Practice Address - Fax:806-383-8789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty