Shannon Elizabeth Matlock
Counseling Psychologist
2175 Academy Cir Ste 200
Colorado Springs
, Colorado 80909-1682
Shannon Elizabeth Matlock
Counseling Psychologist
2175 Academy Cir Ste 200
Colorado Springs
, Colorado 80909-1682
(417) 437-1915
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About
Features
Specialties
- Counseling Psychologist
Languages spoken
- English
Location
First Address
- Shannon Elizabeth Matlock
- 4025 Darby Cir E
- Colorado Springs, CO
- Zip : 80907-3936
- Phone : (417) 437-1915
Second Address
- Shannon Elizabeth Matlock
- 2175 Academy Cir Ste 200
- Colorado Springs, CO
- Zip : 80909-1682
- Phone : (719) 345-2424
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TC1900X | Counseling Psychologist | 0016900 | CO |
National Provider Identifier
| NPI | 1023624384 |
|---|---|
| Provider Name | Shannon Elizabeth Matlock |
| First Address | Colorado Springs, CO 80907-3936 |
| Second Address | Colorado Springs, CO 80909-1682 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/09/2020 |
| Last Update Date | 21/09/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0016900 | DORA (01) | CO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.