Provider Demographics
NPI:1427299643
Name:WHITNEY, SHAWN B (MS, LMFT)
Entity type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:B
Last Name:WHITNEY
Suffix:
Gender:M
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1136 E STUART ST
Mailing Address - Street 2:SUITE 3120
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1195
Mailing Address - Country:US
Mailing Address - Phone:970-999-4499
Mailing Address - Fax:970-461-2462
Practice Address - Street 1:1136 E STUART ST
Practice Address - Street 2:SUITE 3120
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-1195
Practice Address - Country:US
Practice Address - Phone:970-999-4499
Practice Address - Fax:970-461-2462
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60064088106H00000X
CO1156106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist