Provider Demographics
NPI:1205359122
Name:SHARON HYATT-DRENNAN, INC
Entity type:Organization
Organization Name:SHARON HYATT-DRENNAN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HYATT-DRENNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-648-2220
Mailing Address - Street 1:322 N TEJON ST STE 204
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1240
Mailing Address - Country:US
Mailing Address - Phone:719-648-2220
Mailing Address - Fax:719-325-7053
Practice Address - Street 1:322 N TEJON ST STE 204
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1240
Practice Address - Country:US
Practice Address - Phone:719-648-2220
Practice Address - Fax:719-325-7053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3255101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO48735361Medicaid