Basic Information
Provider Information
NPI: 1144348830
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOYA
FirstName: SHEILA
MiddleName: JEANETTE
NamePrefix: MS.
NameSuffix:  
Credential: LPCC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1125 6TH ST SE
Address2:  
City: WILLMAR
State: MN
PostalCode: 562014675
CountryCode: US
TelephoneNumber: 3202354613
FaxNumber: 8552606468
Practice Location
Address1: 2135 SOUTHGATE RD
Address2:  
City: COLORADO SPRINGS
State: CO
PostalCode: 809062605
CountryCode: US
TelephoneNumber: 7196334114
FaxNumber: 7196330150
Other Information
ProviderEnumerationDate: 03/27/2007
LastUpdateDate: 10/10/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X2803CON Behavioral Health & Social Service ProvidersCounselorProfessional
101YP2500XCC01338MNY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


Home