Healthcare Provider Details

I. General information

NPI: 1851208805
Provider Name (Legal Business Name): MAXINE SHARRAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4851 INDEPENDENCE ST FL 1
WHEAT RIDGE CO
80033-6715
US

IV. Provider business mailing address

4851 INDEPENDENCE ST FL 1
WHEAT RIDGE CO
80033-6715
US

V. Phone/Fax

Practice location:
  • Phone: 303-425-0300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0023973
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: