MEDICARE: SHAWNA M WIANT LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	1041C0700X	Clinical Social Worker	CSW.09924755	CO

General Provider Information

NPI Number	:	1114049103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWNA M WIANT LCSW

Provider Business Mailing Address
First Line	:	9711 MOSS ROSE CIR
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80129-6438
Country	:	US
Telephone Number	:	303-919-4640
Fax Number	:

Provider Business Practice Location Address
First Line	:	8008 E ARAPAHOE CT STE 100
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-6839
Country	:	US
Telephone Number	:	720-305-6583
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	04/04/2025

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