Provider Demographics
NPI:1356020564
Name:SAGEBRUSH COUNSELING
Entity type:Organization
Organization Name:SAGEBRUSH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:DOTSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:970-576-1717
Mailing Address - Street 1:1330 S BRYANT ST
Mailing Address - Street 2:
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 1:1521 S PEARL ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-2634
Practice Address - Country:US
Practice Address - Phone:785-865-6555
Practice Address - Fax:844-265-8622
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAGEBRUSH COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty