Healthcare Provider Details

I. General information

NPI: 1447877006
Provider Name (Legal Business Name): SHEA LYNN THIELEMANN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2020
Last Update Date: 06/30/2020
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7921 SOUTHPARK PLZ STE 204
LITTLETON CO
80120-4506
US

IV. Provider business mailing address

1001 E BAYAUD AVE APT 1010
DENVER CO
80209-2376
US

V. Phone/Fax

Practice location:
  • Phone: 720-489-8555
  • Fax:
Mailing address:
  • Phone: 979-277-2185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0016039
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: