Basic Information
Provider Information
NPI: 1306200324
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MULLER
FirstName: SHELLEY
MiddleName: LYNNE
NamePrefix: MRS.
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: NASH/JELINEK
OtherFirstName: SHELLEY
OtherMiddleName: LYNNE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 9401 SOUTHWEST FWY
Address2:  
City: HOUSTON
State: TX
PostalCode: 770741407
CountryCode: US
TelephoneNumber: 7139707000
FaxNumber: 7139707246
Practice Location
Address1: 2610 TECHNOLOGY FOREST BLVD
Address2:  
City: THE WOODLANDS
State: TX
PostalCode: 773813904
CountryCode: US
TelephoneNumber: 3468316690
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/06/2016
LastUpdateDate: 07/09/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X68886TXY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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