Provider Demographics
NPI:1588438063
Name:MARIN, SASHA MICHELLE
Entity type:Individual
Prefix:
First Name:SASHA
Middle Name:MICHELLE
Last Name:MARIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16579 MARION ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-7665
Mailing Address - Country:US
Mailing Address - Phone:720-677-1314
Mailing Address - Fax:
Practice Address - Street 1:1325 S COLORADO BLVD STE B705
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3383
Practice Address - Country:US
Practice Address - Phone:720-677-1314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSWC.0000001522104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker