Healthcare Provider Details

I. General information

NPI: 1235680406
Provider Name (Legal Business Name): SHERITHA CHAMBLISS PMHNP-BC, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2016
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 N SAM HOUSTON PKWY E STE A275
HOUSTON TX
77060-3305
US

IV. Provider business mailing address

19314 BRITTANY CREEK DR
SPRING TX
77388-3099
US

V. Phone/Fax

Practice location:
  • Phone: 832-797-1340
  • Fax: 832-295-3287
Mailing address:
  • Phone: 317-345-0880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number817452
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP132449
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP132449
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number79229
License Number StateNM
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number15528
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: