Provider Demographics
NPI:1053044180
Name:DENVER BOULDER COUNSELING PLLC
Entity Type:Organization
Organization Name:DENVER BOULDER COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNERE
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAUGHNESSY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:303-999-5828
Mailing Address - Street 1:287 CENTURY CIR STE 100D
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1684
Mailing Address - Country:US
Mailing Address - Phone:720-295-0578
Mailing Address - Fax:
Practice Address - Street 1:287 CENTURY CIR STE 100D
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1684
Practice Address - Country:US
Practice Address - Phone:720-295-0578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)