Active NPI
Maytha Jane Shofner, LCSW
- Professional Counselor
- Windsor, Co, CO
National Provider Identifier
1225144165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1425
- Practice address
- 628 Main Street, Windsor, Co 80550
329 East 3Rd Street, Loveland, Co 80537
Windsor, Co, CO 80550 - Phone
- (970) 690-8944
- Fax
- (970) 460-0598
- NPI assigned
- Aug 22, 2006
- Last updated
- Mar 24, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1425 | CO | |
| Professional Counselor | 101YP2500X | 1425 | CO | Primary |
Addresses
Primary practice location
628 Main Street, Windsor, Co 80550
329 East 3Rd Street, Loveland, Co 80537
Windsor, Co, CO 80550
Mailing address
1032 Canal Drive
Windsor, CO 80550
Phone (970) 690-8944
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1425 | CO | MD | Mental Health Counselor |
| 20331 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300924800000",
"number": "1225144165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1032 CANAL DRIVE",
"city": "WINDSOR",
"state": "CO",
"postal_code": "80550",
"telephone_number": "970-690-8944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "628 MAIN STREET, WINDSOR, CO 80550",
"address_2": "329 EAST 3RD STREET, LOVELAND, CO 80537",
"city": "WINDSOR, CO",
"state": "CO",
"postal_code": "80550",
"telephone_number": "970-690-8944",
"fax_number": "970-460-0598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOFNER",
"first_name": "MAYTHA",
"middle_name": "JANE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-22",
"last_updated": "2011-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CO",
"license": "1425",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "1425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.