Provider Demographics
NPI:1285941880
Name:HOUSTON, SHELLEY ANN (LMFT)
Entity type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:ANN
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:ANN
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:202 W SUPERIOR ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-1936
Mailing Address - Country:US
Mailing Address - Phone:218-727-5400
Mailing Address - Fax:218-727-0077
Practice Address - Street 1:202 W SUPERIOR ST
Practice Address - Street 2:SUITE 700
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1936
Practice Address - Country:US
Practice Address - Phone:218-727-5400
Practice Address - Fax:218-727-0077
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2236106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist