Provider Demographics
NPI:1134897846
Name:DESERT SAGE INTEGRATIVE CARE & CONSULTING, LLC
Entity type:Organization
Organization Name:DESERT SAGE INTEGRATIVE CARE & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD-WEST
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:480-863-5877
Mailing Address - Street 1:1726 W LINDNER AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-6516
Mailing Address - Country:US
Mailing Address - Phone:480-255-8541
Mailing Address - Fax:
Practice Address - Street 1:3303 S LINDSAY RD STE 125
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-2100
Practice Address - Country:US
Practice Address - Phone:480-863-5877
Practice Address - Fax:480-393-4926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-30
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty