Provider Demographics
NPI:1417565284
Name:LUGO, SARA (LSW)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:
Last Name:LUGO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6240 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80216-4632
Mailing Address - Country:US
Mailing Address - Phone:720-799-9519
Mailing Address - Fax:
Practice Address - Street 1:6240 SMITH RD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216-4632
Practice Address - Country:US
Practice Address - Phone:720-799-9519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9921182104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker