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Organization
PINE GROVE COUNSELING CENTER LLC
Active
Organization
PINE GROVE COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYDIA SHANNON LCSW (OWNER)
(443) 834-6960
Entity
Organization
Contact information
Practice address
1500 N GRANT ST STE N, DENVER, CO 80203-1859
(443) 834-6960
Mailing address
1500 N GRANT ST STE N, DENVER, CO 80203-1859
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/22/2022
Last updated
03/05/2026
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