Healthcare Provider Details

I. General information

NPI: 1053010769
Provider Name (Legal Business Name): RILEY SHOUBASH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9021 FLOYD DR
PLANO TX
75025-5176
US

IV. Provider business mailing address

9021 FLOYD DR
PLANO TX
75025-5176
US

V. Phone/Fax

Practice location:
  • Phone: 214-277-1145
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number86814
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: