Shannon Booker, LCSW
Social Worker, Clinical in Fort Collins, CO. Individual provider (NPI-1).
NPI number1437742012
StatusActive
Last updated in NPPESJun 1, 2023
Details
- NPI
- 1437742012
- Entity type
- Individual (NPI-1)
- Name
- Shannon Booker
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 15, 2021
- Certification date
- Jun 1, 2023
- Last updated
- Jun 1, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | csw.09926094 | CO | Yes |
Practice location
109 Coronado Ct Bldg 7Fort Collins, CO 80525-4929
Phone 970-795-8419
Mailing address
5017 Prairie Lark LnSeverance, CO 80615-8105
Phone 970-988-4159
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