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General NPI Number Information
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NPI Number | 1326864802
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Entity Type | Organization
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Legal Business Name | SHADOW COUNSELING
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Dates
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Enumeration Date | 11/29/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 3035 W 25TH AVE
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City | DENVER
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State | CO
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Zip | 80211-4635
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Country | US
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Telephone | 303-579-3330
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Fax |
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Provider Business Mailing Address
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Address Line | 2298 S GRAPE ST
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City | DENVER
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State | CO
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Zip | 80222-6263
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Country | US
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Telephone | 303-579-3330
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WALTER AKRY ALMANZA
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Credential | LPC
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Telephone | 303-579-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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