Provider Demographics
NPI:1740831544
Name:GOSSENAUER, SHAUNA (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:
Last Name:GOSSENAUER
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12295 ORACLE BLVD STE 340
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3902
Mailing Address - Country:US
Mailing Address - Phone:719-299-0645
Mailing Address - Fax:
Practice Address - Street 1:12295 ORACLE BLVD STE 340
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3902
Practice Address - Country:US
Practice Address - Phone:719-299-0645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0018387101YP2500X
COLPCC.0017272101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional