Shadoe Underwood, M.S., L.P.C., N.C.C

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC.0017630 Issued in CO

Practice address

711 Barnes Ave
La Junta, CO 81050-2138

Phone

(719) 384-5446

NPI assigned

Jun 11, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shadoe.underwood.p1@direct.vwhs.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Valley-Wide Health Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Alamosa, CO
  • NPI 1790998953

  CO

  Medicare reassignment NPD
• Valley-Wide Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Alamosa, CO
  • NPI 1205652047
  NPD

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1720469166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 BARNES AVE",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810502138",
            "telephone_number": "719-384-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 BARNES AVE",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810502138",
            "telephone_number": "719-384-5446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "SHADOE",
        "credential": "M.S., L.P.C., N.C.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0017630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "credentialing@shgco.org",
            "affiliation": "N",
            "address_1": "711 Barnes Ave",
            "city": "LA Junta",
            "state": "CO",
            "country_code": "US",
            "postal_code": "810502138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lennon Totten, RDH
• Cayla Reanne Townes, M.A.
• David Nathaniel Trujillo, DDS
• Gloria Trujillo
• Nicky R Turner, FNP
• Martin Valdez
• Valley Community Counseling Services, LLC
• Valley Medical Supply
• Valley-Wide Health Systems, Inc
• Valley-Wide Health Systems, Inc.

• All providers in La Junta, CO
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.