Provider Demographics
NPI:1588699003
Name:SAMMONS COX, SHIRLEY FAYE (LPC, LMFT, LCDC)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:FAYE
Last Name:SAMMONS COX
Suffix:
Gender:F
Credentials:LPC, LMFT, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23777 COUNTY ROAD 125
Mailing Address - Street 2:
Mailing Address - City:BEDIAS
Mailing Address - State:TX
Mailing Address - Zip Code:77831-3373
Mailing Address - Country:US
Mailing Address - Phone:832-877-0295
Mailing Address - Fax:832-295-5752
Practice Address - Street 1:23777 COUNTY ROAD 125
Practice Address - Street 2:
Practice Address - City:BEDIAS
Practice Address - State:TX
Practice Address - Zip Code:77831-3373
Practice Address - Country:US
Practice Address - Phone:832-877-0295
Practice Address - Fax:832-295-5752
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1393101YA0400X
TX10083101YM0800X
TX002054106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX027038102Medicaid