Provider Demographics
NPI:1477803898
Name:COLE, SARA (LPC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:COLE
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 1:1770 25TH AVE
Mailing Address - Street 2:#204
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-4947
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1770 25TH AVE
Practice Address - Street 2:#204
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4947
Practice Address - Country:US
Practice Address - Phone:970-682-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7211101YA0400X
CO6357101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)