Provider Demographics
NPI:1740737980
Name:KENNEDY, SARAH ANN (MA)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ANN
Last Name:KENNEDY
Suffix:
Gender:
Credentials:MA
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:KORNEGAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1369 FOREST PARK CIR STE 206
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3485
Mailing Address - Country:US
Mailing Address - Phone:303-917-1675
Mailing Address - Fax:
Practice Address - Street 1:1369 FOREST PARK CIR STE 206
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3485
Practice Address - Country:US
Practice Address - Phone:303-917-1675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
COLPC.0017259101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health