Individual
JO SHIPSHOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW, CAS
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0998609
CO
104100000X
Social Worker
Primary
0009925621
CO
Other
Enumeration date
10/14/2024
Last updated
10/14/2024
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