Healthcare Provider Details

I. General information

NPI: 1144679374
Provider Name (Legal Business Name): AUTISM SERVICES AND PROGRAMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2016
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5275 MARSHALL STREET SUITE 104 AND 204
ARVADA CO
80002
US

IV. Provider business mailing address

5275 MARSHALL STREET SUITE 104 AND 204
ARVADA CO
80002
US

V. Phone/Fax

Practice location:
  • Phone: 928-587-9198
  • Fax: 628-288-7758
Mailing address:
  • Phone: 928-587-9198
  • Fax: 628-288-7758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1-13-12858
License Number StateCO

VIII. Authorized Official

Name: LYDIA CHANEL SHEMWELL
Title or Position: OWNER/OPERATOR
Credential: BCBA
Phone: 928-587-9198