Basic Information
Provider Information | |||||||||
NPI: | 1558401026 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | TOBIN | ||||||||
FirstName: | SHERRI | ||||||||
MiddleName: | LYN | ||||||||
NamePrefix: | MRS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | ED.S,LPC, LPCC, NCC, | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | NEWELL | ||||||||
OtherFirstName: | SHERRI | ||||||||
OtherMiddleName: | LYN | ||||||||
OtherNamePrefix: | MS. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | ED.S, NCSP | ||||||||
OtherLastNameType: | 5 | ||||||||
Mailing Information | |||||||||
Address1: | 9888 W. BELLEVIEW AVE. | ||||||||
Address2: | STE. 2099 | ||||||||
City: | DENVER | ||||||||
State: | CO | ||||||||
PostalCode: | 80123 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5754964049 | ||||||||
FaxNumber: | 5205452120 | ||||||||
Practice Location | |||||||||
Address1: | 9888 W BELLEVIEW AVE STE 2099 | ||||||||
Address2: |   | ||||||||
City: | DENVER | ||||||||
State: | CO | ||||||||
PostalCode: | 801232101 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5754964049 | ||||||||
FaxNumber: | 5205452120 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/07/2007 | ||||||||
LastUpdateDate: | 12/08/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 12/08/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | LPCC0155931 | NM | N |   | Behavioral Health & Social Service Providers | Counselor | Professional | 103TS0200X |   |   | N |   | Behavioral Health & Social Service Providers | Psychologist | School | 103TS0200X |   | AZ | N |   | Behavioral Health & Social Service Providers | Psychologist | School | 103TS0200X | ED ID 3835753 | AZ | N |   | Behavioral Health & Social Service Providers | Psychologist | School | 101YP2500X | LPC0011423 | CO | Y |   | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.