Provider Demographics
NPI:1720741366
Name:BURR, SHELLY (LCSW)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:
Last Name:BURR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8114 BECKETT CREEK LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-3562
Mailing Address - Country:US
Mailing Address - Phone:832-538-3004
Mailing Address - Fax:
Practice Address - Street 1:1618 RIDGEWOOD ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-1034
Practice Address - Country:US
Practice Address - Phone:832-270-4365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-20
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1052381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical