Shawn Denise Quintanilla, LPC-S, LMFT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

65502 Issued in TX

Practice address

1506 Broadway St
Suite 103
Pearland, TX 77581-5838

Phone

(832) 303-3992

Fax

(832) 947-1117

NPI assigned

Jul 8, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 26, 2024 through Jan 26, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shawn D Quintanilla DPC LPC LMFT PLLC

  • Professional Counselor
  • Pearland, TX
  • NPI 1730770330
  NPD Authorized official
• Pearland Psychiatry, PA

  • Psychiatry Physician
  • Pearland, TX
  • NPI 1255609319
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1629333430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 N PARK AVE",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775814216",
            "telephone_number": "281-997-8400",
            "fax_number": "832-997-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 BROADWAY ST",
            "address_2": "SUITE 103",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815838",
            "telephone_number": "832-303-3992",
            "fax_number": "832-947-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTANILLA",
        "first_name": "SHAWN",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "LPC-S, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-08",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "65502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Pearland, TX
• Providers in Pearland, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.