MEDICARE: DR. SHENAN SPRABERRY LPC, PH.D

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	101YM0800X	Mental Health Counselor	68964	TX

General Provider Information

NPI Number	:	1720499767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHENAN SPRABERRY LPC, PH.D

Provider Business Mailing Address
First Line	:	2000 E LAMAR BLVD STE 600
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76006-7361
Country	:	US
Telephone Number	:	817-953-6316
Fax Number	:	817-953-6347

Provider Business Practice Location Address
First Line	:	3000 S HULEN ST STE 124-1320
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-1929
Country	:	US
Telephone Number	:	817-953-6316
Fax Number	:	817-953-6347

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

Provider Enumeration Date	:	05/13/2014
Last Update Date	:	06/12/2024

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