Basic Information
Provider Information
NPI: 1740614429
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FALK
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1055 CLERMONT ST
Address2:  
City: DENVER
State: CO
PostalCode: 802203808
CountryCode: US
TelephoneNumber: 3033998020
FaxNumber: 3033932846
Practice Location
Address1: 1055 CLERMONT ST
Address2:  
City: DENVER
State: CO
PostalCode: 802203808
CountryCode: US
TelephoneNumber: 3033998020
FaxNumber: 3033932846
Other Information
ProviderEnumerationDate: 08/29/2013
LastUpdateDate: 08/29/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X1576COY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


Home