MEDICARE: TONI CHRISTINE SHIFFLET

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	100602	TX
2	101YM0800X	Mental Health Counselor	1038	HI

General Provider Information

NPI Number	:	1588126304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONI CHRISTINE SHIFFLET

Provider Business Mailing Address
First Line	:	515 N HEIGHTS BLVD
Second Line	:
City	:	OMAHA
State	:	TX
Zip	:	75571-2417
Country	:	US
Telephone Number	:	936-727-9951
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 S BROADWAY AVE STE 200
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75702-7344
Country	:	US
Telephone Number	:	936-727-9951
Fax Number	:

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

Provider Enumeration Date	:	04/01/2019
Last Update Date	:	05/14/2026

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Directions to “ TONI CHRISTINE SHIFFLET ” Practice Location

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