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NPI Code Detail

MEDICARE: SHANNON NICOLE GUERNSEY LCSW

MEDICARE: SHANNON NICOLE GUERNSEY 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
1101YM0800XMental Health Counselor68800CA
21041C0700XClinical Social Worker.09925711CO

General Provider Information

NPI Number : 1225402175
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON NICOLE GUERNSEY LCSW
Provider Business Mailing Address
First Line : 1155 KELLY JOHNSON BLVD STE 111
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-3957
Country : US
Telephone Number : 719-373-0051
Fax Number : 719-373-0052
Provider Business Practice Location Address
First Line : 1155 KELLY JOHNSON BLVD STE 111
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-3957
Country : US
Telephone Number : 719-373-0051
Fax Number : 719-373-0052
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2015
Last Update Date : 01/27/2021

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Directions to “ SHANNON NICOLE GUERNSEY LCSW” Practice Location

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