Healthcare Provider Details

I. General information

NPI: 1699127928
Provider Name (Legal Business Name): SKS THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2016
Last Update Date: 07/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1776 S JACKSON ST SUITE 700
DENVER CO
80210-3801
US

IV. Provider business mailing address

1776 S JACKSON ST SUITE 700
DENVER CO
80210-3801
US

V. Phone/Fax

Practice location:
  • Phone: 970-222-7478
  • Fax:
Mailing address:
  • Phone: 970-222-7478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9923319
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number287
License Number StateCO

VIII. Authorized Official

Name: SHANNON SCHOU
Title or Position: OWNER
Credential: LCSW, LAC
Phone: 970-222-7478