MEDICARE: SHEILA THORNTON MCMULLIN 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	82555	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	82555	OTHER	TX	LICENSED PROFESSIONAL COUNSELOR

General Provider Information

NPI Number	:	1962136275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEILA THORNTON MCMULLIN LPC

Provider Business Mailing Address
First Line	:	5907 ERICSON CT
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-5278
Country	:	US
Telephone Number	:	281-374-9207
Fax Number	:

Provider Business Practice Location Address
First Line	:	13910 CHAMPION FOREST DR STE 111
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-1882
Country	:	US
Telephone Number	:	832-432-0301
Fax Number	:

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

Provider Enumeration Date	:	07/12/2022
Last Update Date	:	07/12/2022

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