Healthcare Provider Details

I. General information

NPI: 1750245122
Provider Name (Legal Business Name): DHG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 E 3RD ST
LA JUNTA CO
81050-1907
US

IV. Provider business mailing address

1206 E 3RD ST
LA JUNTA CO
81050-1907
US

V. Phone/Fax

Practice location:
  • Phone: 719-252-2386
  • Fax: 719-888-1767
Mailing address:
  • Phone: 719-252-2386
  • Fax: 719-888-1767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: CHEYENNE ELAINE SHIPMAN
Title or Position: BOARD MEMBER
Credential: PMHNP
Phone: 719-252-2386