Provider Demographics
NPI:1669058426
Name:SHELTON, LINDSAY (MED, LPC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:SHELTON
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20351 HIGHWAY 6 STE B
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-3882
Mailing Address - Country:US
Mailing Address - Phone:979-233-1584
Mailing Address - Fax:
Practice Address - Street 1:20351 HIGHWAY 6 STE B
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-3882
Practice Address - Country:US
Practice Address - Phone:979-233-1584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81580101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health