Provider Demographics
NPI:1538673249
Name:JARVIE, SARAH HANEY
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:HANEY
Last Name:JARVIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1939 PINYON JAY DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80951-4735
Mailing Address - Country:US
Mailing Address - Phone:859-640-5295
Mailing Address - Fax:
Practice Address - Street 1:411 LAKEWOOD CIR STE C201
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-2668
Practice Address - Country:US
Practice Address - Phone:719-302-3175
Practice Address - Fax:859-640-5295
Is Sole Proprietor?:No
Enumeration Date:2017-11-17
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0014644101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health