Provider Demographics
NPI:1720264732
Name:CARLSON, SARAH THERESE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:THERESE
Last Name:CARLSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4790 TABLE MESA DR STE 202
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-5660
Mailing Address - Country:US
Mailing Address - Phone:720-263-0334
Mailing Address - Fax:
Practice Address - Street 1:4790 TABLE MESA DR STE 202
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-5660
Practice Address - Country:US
Practice Address - Phone:720-263-0334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO806106H00000X
106H00000X
CAMFC36338106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist