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General NPI Number Information
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NPI Number | 1194399006
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Entity Type | Organization
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Legal Business Name | SHANNON OBERNDORF
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Dates
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Enumeration Date | 05/14/2021
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Last Update Date | 09/24/2021
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Provider Practice Location Address
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Address Line | 5650 GREENWOOD PLAZA BLVD STE 225B
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-2311
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Country | US
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Telephone | 720-336-0850
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Fax |
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Provider Business Mailing Address
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Address Line | 607 E 10TH AVE APT 4
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City | DENVER
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State | CO
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Zip | 80203-3251
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Country | US
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Telephone | 303-875-2938
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Fax |
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Authorized Official
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Title or Position | PRINCIPLE THERAPIST
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Name | SHANNON OBERNDORF
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Credential | LMFT
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Telephone | 720-336-0850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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