Provider Demographics
NPI:1184193757
Name:LIA SEDGELEY, LCSW, MAC, CACIII, LLC
Entity Type:Organization
Organization Name:LIA SEDGELEY, LCSW, MAC, CACIII, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDGELEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-419-6146
Mailing Address - Street 1:11757 W. KEN CARYL AVE
Mailing Address - Street 2:STE F#143
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-3719
Mailing Address - Country:US
Mailing Address - Phone:303-419-6146
Mailing Address - Fax:303-474-6852
Practice Address - Street 1:7475 W. 5TH AVE
Practice Address - Street 2:STE 201B
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-1675
Practice Address - Country:US
Practice Address - Phone:303-419-6146
Practice Address - Fax:303-474-6852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-13
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000155394Medicaid