Provider Demographics
NPI:1588891105
Name:SHUE, REBECCA JOY (LMSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:JOY
Last Name:SHUE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12703 TOPPER LN
Mailing Address - Street 2:
Mailing Address - City:MANCHACA
Mailing Address - State:TX
Mailing Address - Zip Code:78652-3522
Mailing Address - Country:US
Mailing Address - Phone:512-771-4550
Mailing Address - Fax:512-287-4314
Practice Address - Street 1:12703 TOPPER LN
Practice Address - Street 2:
Practice Address - City:MANCHACA
Practice Address - State:TX
Practice Address - Zip Code:78652-3522
Practice Address - Country:US
Practice Address - Phone:512-771-4550
Practice Address - Fax:512-287-4314
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53066104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX53066OtherLMSW