MEDICARE: NEXGEN COUNSELING & CONSULTING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1134843352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEXGEN COUNSELING & CONSULTING LLC

Provider Business Mailing Address
First Line	:	295 E RENFRO ST STE 300
Second Line	:	PMB 16830955
City	:	BURLESON
State	:	TX
Zip	:	76028-3954
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	295 E RENFRO ST STE 300
Second Line	:	PMB 16830955
City	:	BURLESON
State	:	TX
Zip	:	76028-3954
Country	:	US
Telephone Number	:	682-233-2415
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	DR. SHANDREKA HALL
Credential	:	DSW, LCSW
Telephone Number	:	682-233-2415

Provider Enumeration Date	:	09/30/2022
Last Update Date	:	03/02/2026

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