Individual provider Active NPI

Charlotte Chieko Shintaku, MA

  • Professional Counselor
  • Frisco, CO
National Provider Identifier
1063528479
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3137 Issued in CO
Practice address
120 South 4TH
Frisco, CO 80443
Phone
(970) 668-3478
Fax
(970) 668-0632
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3137 CO Primary

Addresses

Primary practice location

120 South 4TH
Frisco, CO 80443

Mailing address

PO Box 40
Glenwood Springs, CO 81602-0040
Phone (970) 945-2241

Other names 1

  • Charlotte Chieko Shintaku Gordon Former name

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3137COMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1063528479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816020040",
            "telephone_number": "970-945-2241",
            "fax_number": "970-945-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SOUTH 4TH",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "80443",
            "telephone_number": "970-668-3478",
            "fax_number": "970-668-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINTAKU",
        "first_name": "CHARLOTTE",
        "middle_name": "CHIEKO",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "3137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLOTTE",
            "last_name": "SHINTAKU GORDON",
            "middle_name": "CHIEKO",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Frisco, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.