Provider Demographics
NPI:1235664418
Name:LUDWIG, SARA LYNN
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LYNN
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:LYNN
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CAC 1, BS
Mailing Address - Street 1:14221 E HAWAII CIR
Mailing Address - Street 2:UNIT B
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-5828
Mailing Address - Country:US
Mailing Address - Phone:720-539-6719
Mailing Address - Fax:
Practice Address - Street 1:11059 E BETHANY DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2622
Practice Address - Country:US
Practice Address - Phone:303-617-2300
Practice Address - Fax:303-617-2365
Is Sole Proprietor?:No
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACA.0007190101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)