Provider Demographics
NPI:1689161671
Name:RIDGLEY, SHIRLEY A (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:A
Last Name:RIDGLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:SHIRLEY
Other - Middle Name:A
Other - Last Name:RIDGLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:14880 E WAGONTRAIL DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-2154
Mailing Address - Country:US
Mailing Address - Phone:303-906-5330
Mailing Address - Fax:
Practice Address - Street 1:13791 E RICE PL STE 117
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1057
Practice Address - Country:US
Practice Address - Phone:303-906-5330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC0013366101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health