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General NPI Number Information
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NPI Number | 1750833570
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Entity Type | Individual
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Provider Name | SARA SHUCK M.S, LPC, LCDC
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Gender | Female
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Dates
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Enumeration Date | 10/27/2016
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Last Update Date | 04/12/2019
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Provider Practice Location Address
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Address Line | 2519 SCRIPTURE ST
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City | DENTON
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State | TX
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Zip | 76201-2324
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Country | US
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Telephone | 940-381-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1816 S. FM. 51 STE. 400 #105
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City | DECATUR
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State | TX
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Zip | 76234-2346
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Country | US
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Telephone | 940-220-8335
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Fax | 940-612-6029
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 73046
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License Number State | TX
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