Healthcare Provider Details

I. General information

NPI: 1992080600
Provider Name (Legal Business Name): AARON SHENASSA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2011
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S SHERIDAN BLVD
LAKEWOOD CO
80226-8005
US

IV. Provider business mailing address

200 S SHERIDAN BLVD STE 100
LAKEWOOD CO
80226-8010
US

V. Phone/Fax

Practice location:
  • Phone: 720-410-7108
  • Fax:
Mailing address:
  • Phone: 720-410-7108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0024199
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: