Provider Demographics
NPI:1952574451
Name:SHAH, ANISHA (LPC-S)
Entity Type:Individual
Prefix:
First Name:ANISHA
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 S CENTRAL EXPY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-4070
Mailing Address - Country:US
Mailing Address - Phone:469-219-3256
Mailing Address - Fax:469-562-0118
Practice Address - Street 1:120 S CENTRAL EXPY
Practice Address - Street 2:SUITE 107
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-3742
Practice Address - Country:US
Practice Address - Phone:972-542-2945
Practice Address - Fax:972-542-2945
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62341101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor