Provider Demographics
NPI:1275929192
Name:CALLAWAY, SARAH M (LPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:CALLAWAY
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 1:750 E 9TH AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3395
Mailing Address - Country:US
Mailing Address - Phone:720-432-5718
Mailing Address - Fax:
Practice Address - Street 1:750 E 9TH AVE STE 204
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3395
Practice Address - Country:US
Practice Address - Phone:720-432-5718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC0011379101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO79983537Medicaid