Provider Demographics
NPI:1134495963
Name:HARRIS, SHAYLA DANIELLE (MS, LPC)
Entity Type:Individual
Prefix:
First Name:SHAYLA
Middle Name:DANIELLE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:SHAYLA
Other - Middle Name:
Other - Last Name:RUFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:6267 PASSING SKY DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80911-3878
Mailing Address - Country:US
Mailing Address - Phone:334-819-6190
Mailing Address - Fax:
Practice Address - Street 1:1401 POTTER DR STE 101
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-3500
Practice Address - Country:US
Practice Address - Phone:719-660-6292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
COLPC.0015441101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health