Provider Demographics
NPI:1598449514
Name:STOOKSBURY, SHAWN (LPCC)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:STOOKSBURY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:857 SOUTHRIDGE GREENS BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-6740
Mailing Address - Country:US
Mailing Address - Phone:970-231-9578
Mailing Address - Fax:
Practice Address - Street 1:2627 REDWING RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6321
Practice Address - Country:US
Practice Address - Phone:970-413-2264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0020731101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor