Provider Demographics
NPI:1669087052
Name:FAGER, SARITA (MA, LPC)
Entity type:Individual
Prefix:
First Name:SARITA
Middle Name:
Last Name:FAGER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6285 W 66TH AVE
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-4637
Mailing Address - Country:US
Mailing Address - Phone:720-937-9086
Mailing Address - Fax:
Practice Address - Street 1:1300 N 12TH ST STE 550
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2820
Practice Address - Country:US
Practice Address - Phone:520-705-0412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC20801101YM0800X
AZLAC-15775101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor