Provider Demographics
NPI:1063013043
Name:RUMSEY, SHAYLA H (LPC)
Entity type:Individual
Prefix:
First Name:SHAYLA
Middle Name:H
Last Name:RUMSEY
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 1:12004 VISTA RANCH WAY
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-9115
Mailing Address - Country:US
Mailing Address - Phone:682-286-8252
Mailing Address - Fax:
Practice Address - Street 1:1137F BURTON HILL RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76114-4530
Practice Address - Country:US
Practice Address - Phone:682-286-8252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77198101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health