Provider Demographics
NPI:1760948897
Name:BARRETT, SARA (LCSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:HERZOG
Other - Last Name:VAVOULIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1311A N MILDRED RD
Mailing Address - Street 2:
Mailing Address - City:CORTEZ
Mailing Address - State:CO
Mailing Address - Zip Code:81321-2231
Mailing Address - Country:US
Mailing Address - Phone:970-565-6666
Mailing Address - Fax:
Practice Address - Street 1:1311A N MILDRED RD
Practice Address - Street 2:
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321-2231
Practice Address - Country:US
Practice Address - Phone:970-565-8556
Practice Address - Fax:970-564-1134
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW099257051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical