Healthcare Provider Details

I. General information

NPI: 1295553774
Provider Name (Legal Business Name): BRITTNEY BLANCO-SHAW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 W 7TH AVE
DENVER CO
80204-4438
US

IV. Provider business mailing address

1101 W 7TH AVE
DENVER CO
80204-4438
US

V. Phone/Fax

Practice location:
  • Phone: 303-607-0855
  • Fax:
Mailing address:
  • Phone: 720-575-7269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC.0023849
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.0023849
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: