Provider Demographics
NPI:1306168216
Name:MCSHANE, EUGENE H JR (PSYD)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:H
Last Name:MCSHANE
Suffix:JR
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:E. MAC
Other - Middle Name:
Other - Last Name:MCSHANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:950 S CHERRY ST
Mailing Address - Street 2:SUITE 420
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2699
Mailing Address - Country:US
Mailing Address - Phone:303-757-5446
Mailing Address - Fax:303-757-5446
Practice Address - Street 1:950 S CHERRY ST
Practice Address - Street 2:SUITE 420
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-2699
Practice Address - Country:US
Practice Address - Phone:303-757-5446
Practice Address - Fax:303-757-5446
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO793103T00000X, 103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent