| Shoshanna K. Shachtman, Ed.d, Lpc, Ncc | |
|
109 Coronado Ct Fort Collins CO 80525-4929 | |
| (720) 380-3725 | |
| Not Available |
| Full Name | Shoshanna K. Shachtman, Ed.d, Lpc, Ncc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 109 Coronado Ct, Fort Collins, Colorado |
| Authorized Official Name and Position | Shosnanna Kozberg Shachtman (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 7203803725 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shoshanna K. Shachtman, Ed.d, Lpc, Ncc 109 Coronado Ct Fort Collins CO 80525-4929 Ph: (720) 380-3725 | Shoshanna K. Shachtman, Ed.d, Lpc, Ncc 109 Coronado Ct Fort Collins CO 80525-4929 Ph: (720) 380-3725 |
| NPI Number | 1164873519 |
|---|---|
| Provider Enumeration Date | 06/27/2016 |
| Last Update Date | 06/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164873519 | NPI | - | NPPES |
| 20131223174 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0012079 (Colorado) | Primary |
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