1659422020 NPI number — MS. SHELLEY KAUFHER LAZEAR LCSW

Table of content: MS. SHELLEY KAUFHER LAZEAR LCSW (NPI 1659422020)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659422020 NPI number — MS. SHELLEY KAUFHER LAZEAR LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAZEAR
Provider First Name:
SHELLEY
Provider Middle Name:
KAUFHER
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KAUFHER
Provider Other First Name:
SHELLEY
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1659422020
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6180 S FULTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ENGLEWOOD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80111-5423
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-771-1858
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3540 S POPLAR ST
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80237-1360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-523-6020
Provider Business Practice Location Address Fax Number:
303-771-5254
Provider Enumeration Date:
01/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  989558 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com