Provider Demographics
NPI:1184442485
Name:SAGE PSYCHIATRY PLLC
Entity type:Organization
Organization Name:SAGE PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:GOGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP, APRN
Authorized Official - Phone:208-867-5066
Mailing Address - Street 1:801 N WEBER ST STE 205
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-5927
Mailing Address - Country:US
Mailing Address - Phone:208-867-5066
Mailing Address - Fax:833-605-4033
Practice Address - Street 1:801 N WEBER ST STE 205
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-5927
Practice Address - Country:US
Practice Address - Phone:208-867-5066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty