Provider Demographics
NPI:1649053174
Name:SHUMAR, MORGAN B (LPC-A)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:B
Last Name:SHUMAR
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:B
Other - Last Name:ARDREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4 LAKE FOREST CT
Mailing Address - Street 2:
Mailing Address - City:TROPHY CLUB
Mailing Address - State:TX
Mailing Address - Zip Code:76262-5504
Mailing Address - Country:US
Mailing Address - Phone:918-606-6563
Mailing Address - Fax:
Practice Address - Street 1:440 JOHNSON RD STE C
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3465
Practice Address - Country:US
Practice Address - Phone:918-606-6563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92126101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional