Provider Demographics
NPI:1174928345
Name:ALSUM, SHARLA KAE (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:SHARLA
Middle Name:KAE
Last Name:ALSUM
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 S COLLEGE AVE STE 1&2
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4116
Mailing Address - Country:US
Mailing Address - Phone:970-541-0596
Mailing Address - Fax:
Practice Address - Street 1:1502 S COLLEGE AVE STE 1&2
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4116
Practice Address - Country:US
Practice Address - Phone:970-541-0596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0013789101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO329646OtherNATIONAL BOARD OF CERTIFIED COUNSELORS