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NPI Code Detail

MEDICARE: SHANELE RENEE MARQUEZ LPCC MS, INTERN

MEDICARE: SHANELE RENEE MARQUEZ LPCC MS, INTERN
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
1101YP2500XProfessional CounselorCO

General Provider Information

NPI Number : 1992632103
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANELE RENEE MARQUEZ LPCC MS, INTERN
Provider Business Mailing Address
First Line : 2101 FLORENCE ST APT A
Second Line :
City : CANON CITY
State : CO
Zip : 81212-2576
Country : US
Telephone Number : 719-285-9276
Fax Number :
Provider Business Practice Location Address
First Line : 107 S 9TH ST
Second Line :
City : CANON CITY
State : CO
Zip : 81212-3800
Country : US
Telephone Number : 719-285-9276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2026
Last Update Date : 05/04/2026

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