Provider Demographics
NPI:1811735095
Name:SHELTON, SARAH MARIE BRADLEY
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE BRADLEY
Last Name:SHELTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MARIE
Other - Last Name:BRADLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16735 BEAUMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:MEAD
Mailing Address - State:CO
Mailing Address - Zip Code:80542-8905
Mailing Address - Country:US
Mailing Address - Phone:303-902-9640
Mailing Address - Fax:
Practice Address - Street 1:16735 BEAUMONT BLVD
Practice Address - Street 2:
Practice Address - City:MEAD
Practice Address - State:CO
Practice Address - Zip Code:80542-8905
Practice Address - Country:US
Practice Address - Phone:303-902-9640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0020066101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health