| Doctor Name: | MS. KELSEY BROOKE SHANE |
| NPI Number: | 1023451705 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA |
| License Number: | LPC.0012322 |
| Business Practice Address: | 8931 Huron St Thornton, CO - 802606806 |
| Business Phone Number: | 3038533500 |
| Business Fax Number: | |
| Mailing Address: | 2551 Spruce St, DENVER |
| State: | CO |
| Postal Code: | 802382449 |
| Phone Number: | 3039298636 |
| Fax Number: | |
| NPI Enumeration Date: | 04/11/2013 |
| NPI Last Update Date: | 08/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LPC.0012322 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |