Healthcare Provider Details

I. General information

NPI: 1174442156
Provider Name (Legal Business Name): SHACHAR GOLDWATER LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16350 E ARAPAHOE RD UNIT 108
FOXFIELD CO
80016-1557
US

IV. Provider business mailing address

5726 S PAGOSA WAY
CENTENNIAL CO
80015-3014
US

V. Phone/Fax

Practice location:
  • Phone: 720-593-9654
  • Fax:
Mailing address:
  • Phone: 720-593-9654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT.0003225
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: