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General NPI Number Information
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NPI Number | 1518369164
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Entity Type | Individual
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Provider Name | SARAH OLIVIA SHYNE LPC
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Gender | Female
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Dates
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Enumeration Date | 09/25/2014
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 17625 EL CAMINO REAL STE 220
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City | HOUSTON
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State | TX
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Zip | 77058-3075
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Country | US
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Telephone | 832-846-6206
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Fax |
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Provider Business Mailing Address
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Address Line | 1306 MARINA BAY DR APT 209C
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City | KEMAH
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State | TX
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Zip | 77565-2493
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Country | US
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Telephone | 713-855-1836
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 74983
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 001600
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License Number State | IA
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