Provider Demographics
NPI:1790801090
Name:WELLS, SARAH ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANN
Last Name:WELLS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:994 PASQUE DR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-3929
Mailing Address - Country:US
Mailing Address - Phone:206-847-8547
Mailing Address - Fax:
Practice Address - Street 1:994 PASQUE DR
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80504-3929
Practice Address - Country:US
Practice Address - Phone:720-684-7857
Practice Address - Fax:828-665-4354
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0005458101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6244317OtherUBH PROVIDER NUM
NC1136QOtherBCBSNC INDIV PROVIDER NUM
NC6102175Medicaid