Provider Demographics
NPI:1740335348
Name:SHEA, ARIEL (LCSW)
Entity type:Individual
Prefix:MS
First Name:ARIEL
Middle Name:
Last Name:SHEA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ARIEL
Other - Middle Name:
Other - Last Name:ROTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:90 MADISON ST
Mailing Address - Street 2:SUITE 405
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5418
Mailing Address - Country:US
Mailing Address - Phone:720-226-6697
Mailing Address - Fax:
Practice Address - Street 1:90 MADISON ST
Practice Address - Street 2:SUITE 405
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5418
Practice Address - Country:US
Practice Address - Phone:720-226-6697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW-12031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical