Healthcare Provider Details

I. General information

NPI: 1295187375
Provider Name (Legal Business Name): SHON RACHELLE MCDONALD CAS, BSW, MS, DVOMB
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 N ACADEMY BLVD
COLORADO SPRINGS CO
80909-1507
US

IV. Provider business mailing address

2155 N ACADEMY BLVD
COLORADO SPRINGS CO
80909-1507
US

V. Phone/Fax

Practice location:
  • Phone: 719-660-2089
  • Fax:
Mailing address:
  • Phone: 719-660-2089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1537-03
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1537-03
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: