Provider Demographics
NPI:1669877593
Name:VENDEGNA, SARAH (MS, LPC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:VENDEGNA
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 W MYRTLE ST STE 205
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-2917
Mailing Address - Country:US
Mailing Address - Phone:337-321-3229
Mailing Address - Fax:
Practice Address - Street 1:211 W MYRTLE ST STE 205
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-2917
Practice Address - Country:US
Practice Address - Phone:337-321-3229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CO13558101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health