Provider Demographics
NPI:1710680368
Name:SAGEBRUSH COUNSELING
Entity Type:Organization
Organization Name:SAGEBRUSH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AND CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:DOTSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT
Authorized Official - Phone:970-576-1717
Mailing Address - Street 1:844-265-8622
Mailing Address - Street 2:1330 S. BRYANT ST.
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-4220
Mailing Address - Country:US
Mailing Address - Phone:785-865-6555
Mailing Address - Fax:844-265-8622
Practice Address - Street 1:548 FRONT ST
Practice Address - Street 2:
Practice Address - City:FAIRPLAY
Practice Address - State:CO
Practice Address - Zip Code:80440-5001
Practice Address - Country:US
Practice Address - Phone:785-865-6555
Practice Address - Fax:844-265-8622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty