MEDICARE: KELLEE SHEA ANGER M.ED., LPC-ASSOCIATE

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	101Y00000X	Counselor		TX

General Provider Information

NPI Number	:	1508646944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLEE SHEA ANGER M.ED., LPC-ASSOCIATE

Provider Business Mailing Address
First Line	:	2300 WOODFOREST PKWY N STE 250-120
Second Line	:
City	:	MONTGOMERY
State	:	TX
Zip	:	77316-6501
Country	:	US
Telephone Number	:	832-906-0923
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 WOODFOREST PKWY N STE 250-120
Second Line	:
City	:	MONTGOMERY
State	:	TX
Zip	:	77316-6501
Country	:	US
Telephone Number	:	832-514-2565
Fax Number	:

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

Provider Enumeration Date	:	10/03/2023
Last Update Date	:	10/03/2023

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