Provider Demographics
NPI:1255397022
Name:GALBRETH, SANDRA L (LPC LISAC NBCC)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:L
Last Name:GALBRETH
Suffix:
Gender:F
Credentials:LPC LISAC NBCC
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 E MAIN SUITE B2
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401
Mailing Address - Country:US
Mailing Address - Phone:970-209-7159
Mailing Address - Fax:970-249-7159
Practice Address - Street 1:1100 E MAIN SUITE B2
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401
Practice Address - Country:US
Practice Address - Phone:970-209-7159
Practice Address - Fax:970-249-7159
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI86101YM0800X
AZ10126101YM0800X
CO388101YP2500X
AZ0900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO134205Medicaid