1447853015 NPI number — DEBORAH DENISE SAWATZKY MA, LPCC

Table of content: DEBORAH DENISE SAWATZKY MA, LPCC (NPI 1447853015)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447853015 NPI number — DEBORAH DENISE SAWATZKY MA, LPCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAWATZKY
Provider First Name:
DEBORAH
Provider Middle Name:
DENISE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, LPCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GRANDY
Provider Other First Name:
DEBORAH
Provider Other Middle Name:
DENISE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447853015
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/17/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
51 W 84TH AVE STE 220
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
THORNTON
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80260-4882
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-441-3215
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
51 W 84TH AVE STE 220
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
THORNTON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80260-4882
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-441-3215
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/17/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  LPCC.0017868 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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