Provider Demographics
NPI:1659087195
Name:SANDS, HAILEY KEEGAN
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:KEEGAN
Last Name:SANDS
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 1:12954 W ILIFF AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-4336
Mailing Address - Country:US
Mailing Address - Phone:303-954-4052
Mailing Address - Fax:303-399-8010
Practice Address - Street 1:1490 N LAFAYETTE ST STE 108
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-2391
Practice Address - Country:US
Practice Address - Phone:303-954-4052
Practice Address - Fax:303-399-8010
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0015847101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional