Provider Demographics
NPI:1528638541
Name:SHEPHERD, CHRISTA JOY (MA, LPC)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:JOY
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:CHRISTA
Other - Middle Name:JOY
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:8700 E JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-1551
Mailing Address - Country:US
Mailing Address - Phone:281-309-2615
Mailing Address - Fax:
Practice Address - Street 1:2855 N SPEER BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-4239
Practice Address - Country:US
Practice Address - Phone:970-446-9456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-30
Last Update Date:2023-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0017068101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAR178268OtherCPH