Provider Demographics
NPI:1568761625
Name:SARGENT, ADAM MICHAEL (MS)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:MICHAEL
Last Name:SARGENT
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 S COLLEGE AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3002
Mailing Address - Country:US
Mailing Address - Phone:719-494-4637
Mailing Address - Fax:
Practice Address - Street 1:506 S COLLEGE AVE
Practice Address - Street 2:SUITE D
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3002
Practice Address - Country:US
Practice Address - Phone:719-494-4637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor