Shannon Cardona

Individual provider Active NPI Professional Counselor · Maxwell, TX

NPI 1639723844 · NPPES record last updated Dec 10, 2025

Key facts

NPI
1639723844
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
75142 (TX)
Practice address
129 Delta CRST
Maxwell, TX 78656-2050
Phone
(512) 796-4280
NPI assigned
Jul 25, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
75142TXMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 75142 TX Yes

Addresses

Primary practice location

129 Delta CRST
Maxwell, TX 78656-2050

Mailing address

129 Delta CRST
Maxwell, TX 78656-2050
Phone (512) 796-4280

Other providers in Maxwell, TX

All providers in Maxwell, TX · Professional Counselor in Texas

Sources for this page

Verify at the official NPI Registry.