MEDICARE: SHANNA DANIELLE SCOTT 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	101YM0800X	Mental Health Counselor	NLC.0103863	CO
2	101YP2500X	Professional Counselor	LPC.0012759	CO

General Provider Information

NPI Number	:	1619391125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNA DANIELLE SCOTT LPC

Provider Business Mailing Address
First Line	:	2733 S DEPEW ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80227-4106
Country	:	US
Telephone Number	:	303-565-7166
Fax Number	:

Provider Business Practice Location Address
First Line	:	2733 S DEPEW ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80227-4106
Country	:	US
Telephone Number	:	303-565-7166
Fax Number	:

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

Provider Enumeration Date	:	02/05/2014
Last Update Date	:	02/04/2026

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