Provider Demographics
NPI:1881464287
Name:KARUNARATNE, HETTIYADURA SHENELLA (LPC)
Entity type:Individual
Prefix:
First Name:HETTIYADURA
Middle Name:SHENELLA
Last Name:KARUNARATNE
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 1:7552 ROSE CREST BLVD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:TX
Mailing Address - Zip Code:76140-2097
Mailing Address - Country:US
Mailing Address - Phone:940-247-1379
Mailing Address - Fax:
Practice Address - Street 1:4901 WINDHAVEN PKWY STE 200
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-6828
Practice Address - Country:US
Practice Address - Phone:940-247-1379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88875101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional