Provider Demographics
NPI:1235751454
Name:KHALSA, SAT TARA KAUR (LPC)
Entity Type:Individual
Prefix:
First Name:SAT TARA
Middle Name:KAUR
Last Name:KHALSA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4467 ABERDEEN CT
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-4042
Mailing Address - Country:US
Mailing Address - Phone:303-530-7080
Mailing Address - Fax:303-530-4123
Practice Address - Street 1:4467 ABERDEEN CT
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-4042
Practice Address - Country:US
Practice Address - Phone:303-530-7080
Practice Address - Fax:303-530-4123
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001412101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health