Provider Demographics
NPI:1053536821
Name:JOYNER, SHAWN EVETTE (NMD)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:EVETTE
Last Name:JOYNER
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:DR
Other - First Name:SHAWN
Other - Middle Name:EVETTE JOYNER
Other - Last Name:HEFFERON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NMD
Mailing Address - Street 1:1455 DIXON AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-8880
Mailing Address - Country:US
Mailing Address - Phone:303-443-8500
Mailing Address - Fax:
Practice Address - Street 1:1455 DIXON AVE STE 300
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-8880
Practice Address - Country:US
Practice Address - Phone:303-443-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ04-793175F00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty