MEDICARE: DR. SHANNON KELLY BEKMAN PHD

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	103TC2200X	Clinical Child & Adolescent Psychologist	PSY.0003563	CO

General Provider Information

NPI Number	:	1184933772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANNON KELLY BEKMAN PHD

Provider Business Mailing Address
First Line	:	1780 S BELLAIRE ST STE 125
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-4467
Country	:	US
Telephone Number	:	720-432-3836
Fax Number	:

Provider Business Practice Location Address
First Line	:	1780 S BELLAIRE ST STE 125
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-4467
Country	:	US
Telephone Number	:	720-432-3836
Fax Number	:

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

Provider Enumeration Date	:	09/29/2010
Last Update Date	:	05/25/2026

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