Provider Demographics
NPI:1366910614
Name:SCHIMELPFENING, SHANNON (LPC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:SCHIMELPFENING
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 1:19315 FM 2252 STE 304
Mailing Address - Street 2:
Mailing Address - City:GARDEN RIDGE
Mailing Address - State:TX
Mailing Address - Zip Code:78266-2553
Mailing Address - Country:US
Mailing Address - Phone:210-702-9562
Mailing Address - Fax:
Practice Address - Street 1:19315 FM 2252 STE 304
Practice Address - Street 2:
Practice Address - City:GARDEN RIDGE
Practice Address - State:TX
Practice Address - Zip Code:78266-2553
Practice Address - Country:US
Practice Address - Phone:210-702-9562
Practice Address - Fax:210-714-9639
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-05
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72299101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health