Provider Demographics
NPI:1982392551
Name:TELEPAK, SHAUNTENETTE (LCSW)
Entity type:Individual
Prefix:
First Name:SHAUNTENETTE
Middle Name:
Last Name:TELEPAK
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10127 MOROCCO ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-3943
Mailing Address - Country:US
Mailing Address - Phone:210-570-0724
Mailing Address - Fax:
Practice Address - Street 1:3587 KING TER
Practice Address - Street 2:
Practice Address - City:BULVERDE
Practice Address - State:TX
Practice Address - Zip Code:78163-2562
Practice Address - Country:US
Practice Address - Phone:210-570-0724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1092161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical