MEDICARE: ASHLEY SIMPSON SHIRES 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	LPC.0022457	CO

General Provider Information

NPI Number	:	1881450237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY SIMPSON SHIRES LPC

Provider Business Mailing Address
First Line	:	2839 11TH ST
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80304-3003
Country	:	US
Telephone Number	:	720-217-2429
Fax Number	:

Provider Business Practice Location Address
First Line	:	2839 11TH ST
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80304-3003
Country	:	US
Telephone Number	:	720-217-2429
Fax Number	:

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

Provider Enumeration Date	:	02/23/2024
Last Update Date	:	12/22/2025

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