Provider Demographics
NPI:1295459162
Name:VEGA RODRIGUEZ, SHIRLEY MARIE (LPC)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:MARIE
Last Name:VEGA RODRIGUEZ
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:SHIRLEY
Other - Middle Name:MARIE
Other - Last Name:PERCIAVALLE VEGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:9403 CROWN CREST BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-9048
Mailing Address - Country:US
Mailing Address - Phone:303-269-4410
Mailing Address - Fax:303-269-4411
Practice Address - Street 1:9403 CROWN CREST BLVD STE 300
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-9048
Practice Address - Country:US
Practice Address - Phone:303-269-4410
Practice Address - Fax:303-269-4411
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004086101YP2500X
COLPC.18806101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional