MEDICARE: SHONNIA SPEARS LPC

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	101YP2500X	Professional Counselor	74992	TX

General Provider Information

NPI Number	:	1871002733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHONNIA SPEARS LPC

Provider Business Mailing Address
First Line	:	PO BOX 116300
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75011-6300
Country	:	US
Telephone Number	:	601-867-1981
Fax Number	:

Provider Business Practice Location Address
First Line	:	12959 JUPITER RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75238-5223
Country	:	US
Telephone Number	:	214-221-0132
Fax Number	:

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

Provider Enumeration Date	:	09/22/2017
Last Update Date	:	09/22/2017

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Directions to “ SHONNIA SPEARS LPC” Practice Location

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