Provider Demographics
NPI:1821684630
Name:SAGEWOOD COUNSELING, LLC
Entity Type:Organization
Organization Name:SAGEWOOD COUNSELING, LLC
Other - Org Name:SAGEWOOD COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:F
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-670-9935
Mailing Address - Street 1:879 W 500 S
Mailing Address - Street 2:
Mailing Address - City:HEYBURN
Mailing Address - State:ID
Mailing Address - Zip Code:83336-8703
Mailing Address - Country:US
Mailing Address - Phone:208-670-9935
Mailing Address - Fax:208-878-0495
Practice Address - Street 1:658 OVERLAND AVE STE 8
Practice Address - Street 2:
Practice Address - City:BURLEY
Practice Address - State:ID
Practice Address - Zip Code:83318-1300
Practice Address - Country:US
Practice Address - Phone:208-670-9935
Practice Address - Fax:208-878-0495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-15
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1396137527Medicaid