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Organization

INNER SELF AND WISDOM, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JASON SHANKLE MA, LPCC, LACC, CMIT (CEO AND FOUNDER)
(720) 975-4368
Entity
Organization

Contact information

Practice address
12101 E 2ND AVE, AURORA, CO 80011-8327
(720) 975-4368
Mailing address
15703 E CASPIAN CIR APT 201, AURORA, CO 80013-6314
(720) 975-4368

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
LPCC.0013487
CO
251S00000X
Community/Behavioral Health Agency
Primary
NLC.0107047
CO

Other

Enumeration date
02/28/2017
Last updated
02/28/2017
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