Provider Demographics
NPI:1326172347
Name:MILMOE, SARA L (MS, LPC, CACIII)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:L
Last Name:MILMOE
Suffix:
Gender:F
Credentials:MS, LPC, CACIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 GEORGETOWN RD
Mailing Address - Street 2:SMCRS
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-6445
Mailing Address - Country:US
Mailing Address - Phone:303-829-8805
Mailing Address - Fax:
Practice Address - Street 1:2475 BROADWAY ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-4249
Practice Address - Country:US
Practice Address - Phone:303-829-8805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6030101YA0400X
CO3243101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)