MEDICARE: MRS. JAEL SHACKLEFORD 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	101YM0800X	Mental Health Counselor	87771	TX
2	101YS0200X	School Counselor	87771	TX
3	101YP2500X	Professional Counselor	87771	TX

General Provider Information

NPI Number	:	1548009731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JAEL SHACKLEFORD LPC ASSOCIATE

Provider Business Mailing Address
First Line	:	1400 STEVE DR
Second Line	:
City	:	CROWLEY
State	:	TX
Zip	:	76036-1382
Country	:	US
Telephone Number	:	678-431-1327
Fax Number	:

Provider Business Practice Location Address
First Line	:	7550 FM 1187 W
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76126-5109
Country	:	US
Telephone Number	:	888-744-2779
Fax Number	:

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

Provider Enumeration Date	:	05/20/2024
Last Update Date	:	05/20/2024

Similar Medicare Providers

1932791753 — MRS. KATHRYN ANNE RAMIREZ LPC-A
Practice Location Address:

7550 FM 1187 W
FORT WORTH, TX
76126-5109

Practice Phone: 888-744-2779
Practice Fax:

1134900681 — MS. MORGAN LANE MOORE CSC, LPC-ASSOCIATE
Practice Location Address:

7550 FM 1187 W
FORT WORTH, TX
76126-5109

Practice Phone: 888-744-2779
Practice Fax:

1740093046 — HOLLIE GLOVER
Practice Location Address:

7550 FM 1187 W
FORT WORTH, TX
76126-5109

Practice Phone: 888-744-2779
Practice Fax:

1578448544 — JENNIFER LEIGH BORDERS
Practice Location Address:

7550 FM 1187 W
FT WORTH, TX
76126-5109

Practice Phone: 817-771-3236
Practice Fax:

1720132087 — DR. RICHARD L MARTIN DDS
Practice Location Address:

5109 BRENTWOOD STAIR RD
FORT WORTH, TX
76112-2809

Practice Phone: 817-457-4078
Practice Fax: 817-446-5888

1083898332 — WENDY ANN JENKS CRNA
Practice Location Address:

5109 EMMERYVILLE LN
FORT WORTH, TX
76244-6046

Practice Phone: 214-695-0737
Practice Fax:

Directions to “ MRS. JAEL SHACKLEFORD LPC ASSOCIATE” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.