Provider Demographics
NPI:1528670403
Name:MCCAUL-PARENT, SHELLEY ANN (LPC)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:ANN
Last Name:MCCAUL-PARENT
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 1:15527 SAINT CLOUD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-3522
Mailing Address - Country:US
Mailing Address - Phone:832-466-1505
Mailing Address - Fax:
Practice Address - Street 1:15527 SAINT CLOUD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-3522
Practice Address - Country:US
Practice Address - Phone:832-466-1505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT102586225700000X
TX81206101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist