Provider Demographics
NPI:1770002891
Name:SHOJI, KRISTY (PHD, ABPP)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:SHOJI
Suffix:
Gender:F
Credentials:PHD, ABPP
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:LYNN
Other - Last Name:DOUGLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9449 YALE LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-3726
Mailing Address - Country:US
Mailing Address - Phone:970-805-0716
Mailing Address - Fax:
Practice Address - Street 1:9449 YALE LN
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-3726
Practice Address - Country:US
Practice Address - Phone:970-805-0716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-11
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0004662101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor