Provider Demographics
NPI:1639890874
Name:KARRICK, SHAUN JOSEPH
Entity Type:Individual
Prefix:
First Name:SHAUN
Middle Name:JOSEPH
Last Name:KARRICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6421 S CLERMONT CT
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80121-3212
Mailing Address - Country:US
Mailing Address - Phone:303-910-1852
Mailing Address - Fax:
Practice Address - Street 1:6421 S CLERMONT CT
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80121-3212
Practice Address - Country:US
Practice Address - Phone:303-910-1852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician