Healthcare Provider Details

I. General information

NPI: 1871273375
Provider Name (Legal Business Name): SANDOVAL THERAPY AND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N GRANT ST STE R
DENVER CO
80203-1859
US

IV. Provider business mailing address

6732 W COAL MINE AVE PMB 139
LITTLETON CO
80123-4573
US

V. Phone/Fax

Practice location:
  • Phone: 319-855-7899
  • Fax: 303-496-0786
Mailing address:
  • Phone: 319-855-7899
  • Fax: 303-496-0786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. JACOB ANDREW SANDOVAL
Title or Position: OWNER/ADMINISTRATOR
Credential: PHD, LMFT
Phone: 319-855-7899