MEDICARE: SABRINA ROSE HERSTEDT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1649055187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SABRINA ROSE HERSTEDT

Provider Business Mailing Address
First Line	:	11100 W 8TH AVE STE 200
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80215-5553
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11100 W 8TH AVE STE 200
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80215-5553
Country	:	US
Telephone Number	:	720-853-8850
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2023
Last Update Date	:	08/30/2023

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Directions to “ SABRINA ROSE HERSTEDT ” Practice Location

Language	Start Address	Practice Location

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