Provider Demographics
NPI:1013261577
Name:SAWYER, KENNETH CHARLES IV (CAC II, BS)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:CHARLES
Last Name:SAWYER
Suffix:IV
Gender:M
Credentials:CAC II, BS
Other - Prefix:
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Mailing Address - Street 1:7373 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-1446
Mailing Address - Country:US
Mailing Address - Phone:303-412-3945
Mailing Address - Fax:303-412-3381
Practice Address - Street 1:7373 BIRCH ST
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-1446
Practice Address - Country:US
Practice Address - Phone:303-412-3945
Practice Address - Fax:303-412-3381
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)