Provider Demographics
NPI:1245094572
Name:DENTON-GILDEA, SHAWNA R
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:R
Last Name:DENTON-GILDEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHAWNA
Other - Middle Name:ROSE
Other - Last Name:GILDEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2803 TIMBERCHASE TRL
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-5559
Mailing Address - Country:US
Mailing Address - Phone:303-358-7167
Mailing Address - Fax:
Practice Address - Street 1:6848 S REVERE PKWY
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3904
Practice Address - Country:US
Practice Address - Phone:303-358-7167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.0009924647104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker