Provider Demographics
NPI:1851189112
Name:ADDICKS, SHIRLEY (LMSW)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:ADDICKS
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22514 CLOVERLAND FIELD DR
Mailing Address - Street 2:
Mailing Address - City:HOCKLEY
Mailing Address - State:TX
Mailing Address - Zip Code:77447-2534
Mailing Address - Country:US
Mailing Address - Phone:832-686-2333
Mailing Address - Fax:
Practice Address - Street 1:22514 CLOVERLAND FIELD DR
Practice Address - Street 2:
Practice Address - City:HOCKLEY
Practice Address - State:TX
Practice Address - Zip Code:77447-2534
Practice Address - Country:US
Practice Address - Phone:832-686-2333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62389104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker