Provider Demographics
NPI:1114744034
Name:KING, SHEHERAZADE S (LPCC)
Entity type:Individual
Prefix:
First Name:SHEHERAZADE
Middle Name:S
Last Name:KING
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:SHER
Other - Middle Name:
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPCC
Mailing Address - Street 1:512 ENTRADA DR
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-4870
Mailing Address - Country:US
Mailing Address - Phone:415-949-0404
Mailing Address - Fax:
Practice Address - Street 1:512 ENTRADA DRIVE
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401
Practice Address - Country:US
Practice Address - Phone:415-949-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0022578101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty