Provider Demographics
NPI:1699933184
Name:MARILYN K SHROYER MS LPC COUNSELING
Entity type:Organization
Organization Name:MARILYN K SHROYER MS LPC COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:SHROYER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:281-427-5208
Mailing Address - Street 1:124 CALDWELL ST
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-1210
Mailing Address - Country:US
Mailing Address - Phone:281-424-9100
Mailing Address - Fax:
Practice Address - Street 1:2802 GARTH RD
Practice Address - Street 2:SUITE 105
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3900
Practice Address - Country:US
Practice Address - Phone:281-427-5208
Practice Address - Fax:281-428-0937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10420101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84802LOtherBLUE CROSS BLUE SHIELD
TX177236001Medicaid
TX831254000OtherMAGELLAN
TX270800OtherCOMPSYCH
TX2279817OtherCIGNA