Shunta Monique Antwi, LPC

Individual provider Active NPI Professional Counselor · League City, TX

NPI 1972834646 · NPPES record last updated Jan 20, 2010

Key facts

NPI
1972834646
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
59441 (TX)
Practice address
2012 Lake Landing Dr
League City, TX 77573-7801
Phone
(281) 785-8115
NPI assigned
Jan 20, 2010
Sex
Female
Sole proprietor
Yes

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
59441TXMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 59441 TX Yes

Addresses

Primary practice location

2012 Lake Landing Dr
League City, TX 77573-7801

Mailing address

2012 Lake Landing Drive
League City, TX 77573
Phone (281) 785-8115

Other providers in League City, TX

All providers in League City, TX · Professional Counselor in Texas

Sources for this page

Verify at the official NPI Registry.