Provider Demographics
NPI:1427691484
Name:SHERBOURNE, LANDON SCOTT (LPCC)
Entity type:Individual
Prefix:MR
First Name:LANDON
Middle Name:SCOTT
Last Name:SHERBOURNE
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 EAST ST UNIT 1770
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:CO
Mailing Address - Zip Code:80466-5072
Mailing Address - Country:US
Mailing Address - Phone:720-545-0785
Mailing Address - Fax:
Practice Address - Street 1:227 ALPINE DR
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:CO
Practice Address - Zip Code:80466-5128
Practice Address - Country:US
Practice Address - Phone:720-545-0785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-22
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO.0020638101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health