Provider Demographics
NPI:1497586655
Name:BAK, SARAH CAMILLE (LPC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:CAMILLE
Last Name:BAK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SARAI
Other - Middle Name:CAMILLE
Other - Last Name:BAK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:3400 S LOWELL BLVD APT 10-105
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80236-2456
Mailing Address - Country:US
Mailing Address - Phone:224-422-8692
Mailing Address - Fax:
Practice Address - Street 1:5161 E ARAPAHOE RD STE 400
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-4811
Practice Address - Country:US
Practice Address - Phone:303-250-1327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0021020101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional