Provider Demographics
NPI:1891493219
Name:SHIFT HEALING
Entity Type:Organization
Organization Name:SHIFT HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LICENSED PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLDUAN LOMAX
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:303-910-0493
Mailing Address - Street 1:3000 YOUNGFIELD ST STE 302
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80215-6545
Mailing Address - Country:US
Mailing Address - Phone:303-800-3458
Mailing Address - Fax:
Practice Address - Street 1:3000 YOUNGFIELD ST STE 302
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80215-6545
Practice Address - Country:US
Practice Address - Phone:303-800-3458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty