Provider Demographics
NPI:1144453101
Name:GREEN, SHELLEY D (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:D
Last Name:GREEN
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 ALPINE RD
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81403-4603
Mailing Address - Country:US
Mailing Address - Phone:970-779-1439
Mailing Address - Fax:
Practice Address - Street 1:907 ALPINE RD
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81403-4603
Practice Address - Country:US
Practice Address - Phone:970-779-1439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0006209101YP2500X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling