Provider Demographics
NPI:1053461574
Name:MCGARRAUGH, SHANNON LEE (LPC, LAC, MAC, SAP)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:LEE
Last Name:MCGARRAUGH
Suffix:
Gender:F
Credentials:LPC, LAC, MAC, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 MEDICAL CENTER PT
Mailing Address - Street 2:#253
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-8732
Mailing Address - Country:US
Mailing Address - Phone:719-634-1825
Mailing Address - Fax:719-634-1874
Practice Address - Street 1:1633 MEDICAL CENTER PT
Practice Address - Street 2:#253
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8732
Practice Address - Country:US
Practice Address - Phone:719-634-1825
Practice Address - Fax:719-634-1874
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO134101YA0400X
CO2485101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health