=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477418515
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NASSER OBAID AL-SHAMESI LPCC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2025
-----------------------------------------------------
Last Update Date | 12/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2116 HOLLOW BROOK DR STE 100
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80918-1443
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-249-0984
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 733 DAFFODIL ST
-----------------------------------------------------
City | FOUNTAIN
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80817-4174
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-246-6680
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | LPCC.0024083
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------