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General NPI Number Information
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NPI Number | 1134625544
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Entity Type | Individual
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Provider Name | KATHLEEN SHOOK
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Gender | Female
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Dates
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Enumeration Date | 04/04/2018
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 6045 S LIMA ST
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City | ENGLEWOOD
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State | CO
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Zip | 80111-5803
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Country | US
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Telephone | 806-265-5523
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Fax |
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Provider Business Mailing Address
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Address Line | 6045 S LIMA ST
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City | ENGLEWOOD
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State | CO
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Zip | 80111-5803
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Country | US
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Telephone | 806-265-5523
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0001461
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0015234
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License Number State | CO
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