MEDICARE: CARRI L SHEHORN M.ED. LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	20269	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093707994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRI L SHEHORN M.ED. LPC

Provider Business Mailing Address
First Line	:	5201 STEINBECK BEND DR
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76708-5204
Country	:	US
Telephone Number	:	254-752-5900
Fax Number	:

Provider Business Practice Location Address
First Line	:	5201 STEINBECK BEND DR
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76708-5204
Country	:	US
Telephone Number	:	254-752-5900
Fax Number	:	254-752-5901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	03/28/2013

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