Healthcare Provider Details

I. General information

NPI: 1184556847
Provider Name (Legal Business Name): LESLIE SHIRKEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7025 TALL OAK DR STE 120
COLORADO SPRINGS CO
80919-2523
US

IV. Provider business mailing address

5030 BOARDWALK DR STE 150
COLORADO SPRINGS CO
80919-3160
US

V. Phone/Fax

Practice location:
  • Phone: 719-644-6215
  • Fax:
Mailing address:
  • Phone: 719-644-6215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTC.0014490
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.0023491
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: