Provider Demographics
NPI:1902297047
Name:SHAIN, LAURA CARSON (LPC, MA, LAC, SOMB)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:CARSON
Last Name:SHAIN
Suffix:
Gender:F
Credentials:LPC, MA, LAC, SOMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9725 W 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-1531
Mailing Address - Country:US
Mailing Address - Phone:251-422-5842
Mailing Address - Fax:
Practice Address - Street 1:10090 W 26TH AVE UNIT 100
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-1400
Practice Address - Country:US
Practice Address - Phone:720-663-7824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-11
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0013936101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor