=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881579118
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHELBY MARIE LOFTIN LPC ASSOCIATE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2025
-----------------------------------------------------
Last Update Date | 08/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1560 W BAY AREA BLVD STE 210
-----------------------------------------------------
City | FRIENDSWOOD
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77546-2669
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-218-8181
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1059 MISTY CLF
-----------------------------------------------------
City | DICKINSON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77539-8378
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-750-1459
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | 95708
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 95708
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------