Provider Demographics
NPI:1306308911
Name:WHITNEY, SHELLY L (LCSW)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:L
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 S COLORADO BLVD STE 604
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3323
Mailing Address - Country:US
Mailing Address - Phone:720-936-6921
Mailing Address - Fax:
Practice Address - Street 1:1325 S COLORADO BLVD STE 604
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3323
Practice Address - Country:US
Practice Address - Phone:720-936-6921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.09925174101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health