Provider Demographics
NPI:1629381942
Name:DUSKE, SHADIA JANIEL (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:SHADIA
Middle Name:JANIEL
Last Name:DUSKE
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 E EVANS AVE
Mailing Address - Street 2:BLDG 1, STE 255
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-5406
Mailing Address - Country:US
Mailing Address - Phone:720-277-6125
Mailing Address - Fax:
Practice Address - Street 1:6000 E EVANS AVE
Practice Address - Street 2:BLDG 1, STE 255
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5406
Practice Address - Country:US
Practice Address - Phone:720-277-6125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6462101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health