{
"Npi": {
"NPI": "1194399006",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SHANNON OBERNDORF",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "607 E 10TH AVE APT 4",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DENVER",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80203-3251",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "303-875-2938",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5650 GREENWOOD PLAZA BLVD STE 225B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GREENWOOD VILLAGE",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80111-2311",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "720-336-0850",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/14/2021",
"LastUpdateDate": "09/24/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OBERNDORF",
"AuthorizedOfficialFirstName": "SHANNON",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRINCIPLE THERAPIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LMFT",
"AuthorizedOfficialTelephoneNumber": "720-336-0850",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0801X",
"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}