Healthcare Provider Details

I. General information

NPI: 1780593517
Provider Name (Legal Business Name): SANDRA J. SCRUGGS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6740 E HAMPDEN AVE STE 208
DENVER CO
80224-3018
US

IV. Provider business mailing address

662 N CLUBVIEW ST
WATKINS CO
80137-8992
US

V. Phone/Fax

Practice location:
  • Phone: 720-653-5418
  • Fax:
Mailing address:
  • Phone: 720-653-5418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: