Embodied Radiance LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

EMBODIED RADIANCE LLC

Practice address

750 E 9TH Ave Ste 100
Denver, CO 80203-3395

Phone

(970) 798-0749

NPI assigned

Dec 20, 2024

Organization subpart

No

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

Authorized official

Name

Kathleen Shea, MA, LPCNPI 1831801398

Title

Founder/Owner

Phone

(970) 798-0749

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Kathleen Shea, COUNSELOR

  • Mental Health Counselor
  • Denver, CO
  • NPI 1831801398
  NPD Authorized official

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

{
    "created_epoch": "1734652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734652800000",
    "number": "1821806951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E 9TH AVE STE 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802033395",
            "telephone_number": "970-798-0749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E 9TH AVE STE 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802033395",
            "telephone_number": "970-798-0749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBODIED RADIANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-20",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A",
        "authorized_official_last_name": "SHEA",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "FOUNDER/OWNER",
        "authorized_official_telephone_number": "970-798-0749",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Denver, CO
• Providers in Denver, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.