MEDICARE: SHANNA MARTINDALE SAADEH LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor
2	101YP2500X	Professional Counselor	LPC.0013689	CO
3	101Y00000X	Counselor

General Provider Information

NPI Number	:	1407171416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNA MARTINDALE SAADEH LPC

Provider Business Mailing Address
First Line	:	9088 RIDGELINE BLVD STE 201
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80129-2380
Country	:	US
Telephone Number	:	720-515-2634
Fax Number	:

Provider Business Practice Location Address
First Line	:	9088 RIDGELINE BLVD STE 201
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80129-2380
Country	:	US
Telephone Number	:	720-515-2634
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2010
Last Update Date	:	05/21/2019

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