Provider Demographics
NPI:1003463548
Name:FORSYTHE, SANDI L (LMFT)
Entity type:Individual
Prefix:
First Name:SANDI
Middle Name:L
Last Name:FORSYTHE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15954 JACKSON CREEK PARKWAY
Mailing Address - Street 2:SUITE B #515
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132
Mailing Address - Country:US
Mailing Address - Phone:888-959-6114
Mailing Address - Fax:303-381-2490
Practice Address - Street 1:15954 JACKSON CREEK PARKWAY
Practice Address - Street 2:SUITE B #515
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132
Practice Address - Country:US
Practice Address - Phone:888-959-6114
Practice Address - Fax:303-381-2490
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLMFT11589106H00000X
COMFT.0001682106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist