| Sagebrush Counseling | |
|
548 Front St Fairplay CO 80440-5001 | |
| (785) 865-6555 | |
| (844) 265-8622 |
| Full Name | Sagebrush Counseling |
|---|---|
| Speciality | Counselor |
| Location | 548 Front St, Fairplay, Colorado |
| Authorized Official Name and Position | Damond Dotson (BILLING AND CREDENTIALING MANAGER) |
| Authorized Official Contact | 9705761717 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sagebrush Counseling 844-265-8622 1330 S. Bryant St. Denver CO 80219-4220 Ph: (785) 865-6555 | Sagebrush Counseling 548 Front St Fairplay CO 80440-5001 Ph: (785) 865-6555 |
| NPI Number | 1710680368 |
|---|---|
| Provider Enumeration Date | 03/23/2023 |
| Last Update Date | 03/23/2023 |
| Certification Date | 03/21/2023 |
| Medicare PECOS PAC ID | 4981043916 |
|---|---|
| Medicare Enrollment ID | O20240423002957 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710680368 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Catherine Sue De Vilder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528739505 PECOS PAC ID: 2062864549 Enrollment ID: I20240119003411 |
| Provider Name | Adam M Fyler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235628199 PECOS PAC ID: 5890134829 Enrollment ID: I20240423003053 |
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