Healthcare Provider Details

I. General information

NPI: 1710043716
Provider Name (Legal Business Name): SHAWNA FISHMAN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHAWNA BETH FISHMAN

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2512 GRAND AVE UNIT 206
GLENWOOD SPRINGS CO
81601-4121
US

IV. Provider business mailing address

2512 GRAND AVE UNIT 206
GLENWOOD SPRINGS CO
81601-4121
US

V. Phone/Fax

Practice location:
  • Phone: 970-310-1747
  • Fax:
Mailing address:
  • Phone: 970-310-1747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1447
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number33408
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT.0001280
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: