Individual provider Active NPI

Shiho Charlene Kelleher

  • School Psychologist
  • Longmont, CO
National Provider Identifier
1003787045
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
Practice address
1703 Whitehall Dr Unit 2C
Longmont, CO 80504-2540
Phone
(720) 217-9508
NPI assigned
Sep 15, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X CO
School Psychologist 103TS0200X ID Primary

Addresses

Primary practice location

1703 Whitehall Dr Unit 2C
Longmont, CO 80504-2540

Mailing address

1703 Whitehall Dr Unit 2C
Longmont, CO 80504-2540
Phone (720) 217-9508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1757894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1003787045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 WHITEHALL DR UNIT 2C",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805042540",
            "telephone_number": "720-217-9508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 WHITEHALL DR UNIT 2C",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805042540",
            "telephone_number": "720-217-9508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEHER",
        "first_name": "SHIHO",
        "middle_name": "CHARLENE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-15",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.