Provider Demographics
NPI:1477740413
Name:PRESTON, SHAWNDY LYON (MC)
Entity Type:Individual
Prefix:MS
First Name:SHAWNDY
Middle Name:LYON
Last Name:PRESTON
Suffix:
Gender:F
Credentials:MC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1454 KIPLING ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-4630
Mailing Address - Country:US
Mailing Address - Phone:303-261-5582
Mailing Address - Fax:
Practice Address - Street 1:621 W. 96TH AVE.
Practice Address - Street 2:
Practice Address - City:THORTON
Practice Address - State:CO
Practice Address - Zip Code:80221
Practice Address - Country:US
Practice Address - Phone:303-427-1386
Practice Address - Fax:303-650-8413
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health