Holly Shaw PHD LPC LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

CO-4122 Issued in CO

Legal business name

HOLLY SHAW PHD LPC LLC

Practice address

2629 Redwing Rd
Suite 114
Fort Collins, CO 80526-6315

Phone

(970) 266-8062

Fax

(970) 266-8082

NPI assigned

Feb 28, 2017

Organization subpart

No

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

Authorized official

Name

Holly Shaw, PHD

Title

Owner

Phone

(970) 266-8062

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1912447632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 REDWING RD",
            "address_2": "SUITE 114",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805266315",
            "telephone_number": "970-266-8062",
            "fax_number": "970-266-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2629 REDWING RD",
            "address_2": "SUITE 114",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805266315",
            "telephone_number": "970-266-8062",
            "fax_number": "970-266-8082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY SHAW PHD LPC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-28",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-266-8062",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CO",
            "license": "CO-4122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Community/Behavioral Health Agency in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; 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.