Provider Demographics
NPI:1194236299
Name:WIND, SHARI J (LPC)
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:J
Last Name:WIND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 30TH ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1022
Mailing Address - Country:US
Mailing Address - Phone:303-819-8775
Mailing Address - Fax:
Practice Address - Street 1:1790 30TH ST STE 270
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1085
Practice Address - Country:US
Practice Address - Phone:303-819-8775
Practice Address - Fax:303-819-8775
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006545101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0006545OtherPROFESSIONAL COUNSELOR