Provider Demographics
NPI:1316640279
Name:POPLAR, SHAWNE (MA LPC)
Entity type:Individual
Prefix:
First Name:SHAWNE
Middle Name:
Last Name:POPLAR
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1079 W ROUND GROVE RD STE 300-537
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-7905
Mailing Address - Country:US
Mailing Address - Phone:940-341-2455
Mailing Address - Fax:
Practice Address - Street 1:2250 MORRISS RD STE 205
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-3242
Practice Address - Country:US
Practice Address - Phone:940-341-2455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70239101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health