Provider Demographics
NPI:1578787008
Name:SHARGEL, PATRICK S (LPC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:S
Last Name:SHARGEL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BOULDER CRESCENT ST
Mailing Address - Street 2:SUITE 204A
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3344
Mailing Address - Country:US
Mailing Address - Phone:719-471-3005
Mailing Address - Fax:719-208-3293
Practice Address - Street 1:10 BOULDER CRESCENT ST
Practice Address - Street 2:SUITE 204A
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3344
Practice Address - Country:US
Practice Address - Phone:719-471-3005
Practice Address - Fax:719-208-3293
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3490101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional