Healthcare Provider Details

I. General information

NPI: 1174206130
Provider Name (Legal Business Name): SHAE LYNN HOCKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHAE LYNN RILEY

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6303 WADSWORTH BLVD
ARVADA CO
80003-4837
US

IV. Provider business mailing address

150 S MONACO PKWY APT 706
DENVER CO
80224-1143
US

V. Phone/Fax

Practice location:
  • Phone: 303-935-7004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0021419
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0002581
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: