Provider Demographics
NPI:1316258924
Name:SURKIS, SARI ANNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:SARI
Middle Name:ANNE
Last Name:SURKIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 HARLAN ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-2344
Mailing Address - Country:US
Mailing Address - Phone:720-460-6938
Mailing Address - Fax:
Practice Address - Street 1:1515 WYNKOOP ST
Practice Address - Street 2:SUITE 360
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-5560
Practice Address - Country:US
Practice Address - Phone:303-546-7971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NY082236104100000X
COCSW.099235521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
12282119OtherCAQH