Provider Demographics
NPI:1992561591
Name:SPECTOR, SHELLEY DEBORAH (LCSW)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:DEBORAH
Last Name:SPECTOR
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 1:4505 BRAEBURN DR
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-5511
Mailing Address - Country:US
Mailing Address - Phone:713-825-4132
Mailing Address - Fax:
Practice Address - Street 1:4505 BRAEBURN DR
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-5511
Practice Address - Country:US
Practice Address - Phone:713-825-4132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2003-1221041C0700X
WA613518971041C0700X
FLTPSW3651041C0700X
TX308031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical