Provider Demographics
NPI:1215685367
Name:SWEETBARK, AMANDA (MS, LPC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:SWEETBARK
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:BARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:1805 S BELLAIRE ST STE 365
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4382
Mailing Address - Country:US
Mailing Address - Phone:303-351-1262
Mailing Address - Fax:
Practice Address - Street 1:1805 S BELLAIRE ST STE 365
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4382
Practice Address - Country:US
Practice Address - Phone:303-351-1262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC-0017958101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLPC-0017958OtherLPC LICENSE