Provider Demographics
NPI:1376720573
Name:EDGELL, SHARI LYNNE (LPC)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:LYNNE
Last Name:EDGELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 TELSTAR DR STE 300
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-1019
Mailing Address - Country:US
Mailing Address - Phone:719-237-4799
Mailing Address - Fax:
Practice Address - Street 1:1755 TELSTAR DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-1019
Practice Address - Country:US
Practice Address - Phone:719-237-4799
Practice Address - Fax:719-644-6401
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5424101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional