Healthcare Provider Details

I. General information

NPI: 1457096471
Provider Name (Legal Business Name): SARAH FREEZE, LCSW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 08/04/2022
Certification Date: 08/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 S CLARKSON ST STE 206
DENVER CO
80210-1627
US

IV. Provider business mailing address

1221 S CLARKSON ST STE 206
DENVER CO
80210-1627
US

V. Phone/Fax

Practice location:
  • Phone: 720-727-7188
  • Fax:
Mailing address:
  • Phone: 720-727-7188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARAH FREEZE
Title or Position: OWNER
Credential:
Phone: 720-727-7188