Provider Demographics
NPI:1477980936
Name:MCTAGGART, SHEA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SHEA
Middle Name:
Last Name:MCTAGGART
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 S STEELE ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-2805
Mailing Address - Country:US
Mailing Address - Phone:720-449-2499
Mailing Address - Fax:720-634-0719
Practice Address - Street 1:50 S STEELE ST
Practice Address - Street 2:SUITE 250
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2805
Practice Address - Country:US
Practice Address - Phone:720-449-2499
Practice Address - Fax:720-634-0719
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004271103TC0700X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical