Provider Demographics
NPI:1578905204
Name:TINKER, SARA JANE (LCSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:JANE
Last Name:TINKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4860 ROBB ST 201
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-2162
Mailing Address - Country:US
Mailing Address - Phone:303-278-7418
Mailing Address - Fax:303-223-9315
Practice Address - Street 1:2003 MARSHY SWAMP PT
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-1632
Practice Address - Country:US
Practice Address - Phone:303-278-7418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN12605328OtherCAQH
TN1046OtherPROFESSIONAL LICENSE