Senior Harbors, Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2181 Issued in CO

Legal business name

SENIOR HARBORS, INC.

Practice address

2118 Chatalet Lane
Pueblo, CO 81005

Phone

(719) 320-3648

Fax

(719) 543-6432

NPI assigned

Oct 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Sherley J. Gonzales, ED.D.

Title

Ceo

Phone

(719) 320-3648

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carlos Jose Rodriguez, PHD

  • Psychologist
  • Pueblo, CO
  • NPI 1841304185
  NPD (past)
• Elizabeth Ann Penland, PH.D.

  • Adult Development & Aging Psychologist
  • Rio Rancho, NM
  • NPI 1558436964
  NPD (past)
• Jose G. Vega, PHD

  • Psychologist
  • Lufkin, TX
  • NPI 1952330441
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189728000000",
    "number": "1114009198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 NORWICH AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081435",
            "telephone_number": "719-320-3648",
            "fax_number": "719-543-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 CHATALET LANE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81005",
            "telephone_number": "719-320-3648",
            "fax_number": "719-543-6432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR HARBORS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-09-14",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "SHERLEY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "719-320-3648",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "2181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23489367",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Selfridge
• Tarah Sellner, FNP-C
• Jesse Lawrence Sena, LPC
• Valerie A Senger, MA, LPC, NCC
• Senior Care Systems of Co Inc
• Senior Resource Develpment Agency, Inc.
• Lenore A Senior, MA, NCC, LPC
• Dwan Austin Senn
• Yuliya Serdyuk
• Moira Annette Sergejev, FNP

• Clinical Psychologist in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; 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.