Provider Demographics
NPI:1487154811
Name:DECAROLIS, SANDRA (NCC, LPC)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:DECAROLIS
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 MALLEY DR
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80233-1928
Mailing Address - Country:US
Mailing Address - Phone:303-457-9576
Mailing Address - Fax:303-335-9102
Practice Address - Street 1:506 MALLEY DR
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80233-1928
Practice Address - Country:US
Practice Address - Phone:303-457-9576
Practice Address - Fax:303-457-9102
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0014106101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional