DERRICK SHAIN PSYCHOTHERAPIST
NPI 1740879410
Counselor - Mental Health in Boulder, CO
Active since January 15, 2021
About Derrick Shain Psychotherapist NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DERRICK SHAIN PSYCHOTHERAPIST (NPI 1740879410) is an individual mental health provider in Boulder, Colorado and active in the NPI registry since January 2021.
NPPES Registry Identity
NPI1740879410
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameDERRICK SHAINCredential: PSYCHOTHERAPIST
Location Address1650 38TH ST STE 100EBoulder, CO 80301-2624
Mailing Address620 Grandview Mdws Dr Unit F205Longmont, CO 80503-8966 · (660) 383-2641
Phone(660) 383-2641
Sole ProprietorYes
Enumeration DateJanuary 15, 2021
NPPES CertifiedJanuary 15, 2021
✔ NPI 1740879410 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
1650 38TH ST STE 100E, Boulder, CO 80301
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
Counselor (Professional)
1650 38TH ST STE 100E
BOULDER, CO 80301
BOULDER, CO 80301
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1740879410, enumerated as an "individual" on January 15, 2021.
The provider is located at 1650 38TH ST STE 100E BOULDER, CO 80301 and the phone number is (660) 383-2641.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.