Provider Demographics
NPI:1609621838
Name:SHIRE FAMILY COUNSELING PLLC
Entity type:Organization
Organization Name:SHIRE FAMILY COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRACKENDORFF
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:832-205-8165
Mailing Address - Street 1:802 GARDEN TRACE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-6342
Mailing Address - Country:US
Mailing Address - Phone:832-205-8615
Mailing Address - Fax:
Practice Address - Street 1:4151 SOUTHWEST FWY STE 720
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7308
Practice Address - Country:US
Practice Address - Phone:832-205-8165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty