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1457720237

NPI Code Detail

MEDICARE: MRS. COSHA SHAWNTELL JOSEPH MS, LPC

MEDICARE: MRS. COSHA SHAWNTELL JOSEPH MS, 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	101YM0800X	Mental Health Counselor	LPC012732	GA
2	101YM0800X	Mental Health Counselor	6250	LA
3	101YM0800X	Mental Health Counselor	80185	TX
4	101YP2500X	Professional Counselor	6250	LA
5	101YP2500X	Professional Counselor	LPC012732	GA
6	101YP2500X	Professional Counselor	80185	TX

General Provider Information

NPI Number	:	1457720237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COSHA SHAWNTELL JOSEPH MS, LPC

Provider Business Mailing Address
First Line	:	11767 KATY FWY STE 1130
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-1731
Country	:	US
Telephone Number	:	832-831-6178
Fax Number	:	832-550-2814

Provider Business Practice Location Address
First Line	:	11767 KATY FWY STE 1130
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-1731
Country	:	US
Telephone Number	:	832-831-6178
Fax Number	:

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

Provider Enumeration Date	:	09/22/2015
Last Update Date	:	01/16/2025

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Directions to “ MRS. COSHA SHAWNTELL JOSEPH MS, LPC” Practice Location

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