Provider Demographics
NPI:1245591866
Name:SHAYLER, MERISSA ANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:MERISSA
Middle Name:ANNE
Last Name:SHAYLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MERISSA
Other - Middle Name:
Other - Last Name:PICKELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:340 E 1ST AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-2454
Mailing Address - Country:US
Mailing Address - Phone:720-370-8329
Mailing Address - Fax:
Practice Address - Street 1:340 E 1ST AVE STE 300
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-2454
Practice Address - Country:US
Practice Address - Phone:720-370-8329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
COCSW.099273021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator