Provider Demographics
NPI:1891457503
Name:SHOEMAKER, ELLEN ANNE
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:ANNE
Last Name:SHOEMAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:ANNE
Other - Last Name:CHABIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1460 S CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3555
Mailing Address - Country:US
Mailing Address - Phone:720-244-8123
Mailing Address - Fax:
Practice Address - Street 1:7955 E ARAPAHOE CT STE 1425
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-6848
Practice Address - Country:US
Practice Address - Phone:720-244-8123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-10
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC0017584101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional