Provider Demographics
NPI:1386264273
Name:HOLT, SHACORA RENEE (LPC)
Entity type:Individual
Prefix:MS
First Name:SHACORA
Middle Name:RENEE
Last Name:HOLT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:SHACORA
Other - Middle Name:RENEE
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3050 POST OAK BLVD STE 510
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-6512
Mailing Address - Country:US
Mailing Address - Phone:717-599-2817
Mailing Address - Fax:
Practice Address - Street 1:3050 POST OAK BLVD STE 510
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-6512
Practice Address - Country:US
Practice Address - Phone:717-599-2817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-20
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012217101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional