MEDICARE: SHAWNEE KEY

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	101Y00000X	Counselor	100521	TX

General Provider Information

NPI Number	:	1699635359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWNEE KEY

Provider Business Mailing Address
First Line	:	3705 FOUNTAIN TER
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79106-6324
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3705 FOUNTAIN TER
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79106-6324
Country	:	US
Telephone Number	:	806-674-0775
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2025
Last Update Date	:	11/14/2025

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Directions to “ SHAWNEE KEY ” Practice Location

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