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NPI Code Detail

MEDICARE: SAGEWOOD HEALING, LLC

MEDICARE: SAGEWOOD HEALING, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC1900XCounseling Psychologist

General Provider Information

NPI Number : 1114719887
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAGEWOOD HEALING, LLC
Provider Business Mailing Address
First Line : PO BOX 42
Second Line :
City : COLUMBUS
State : WI
Zip : 53925-0042
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 635 PARK AVE STE 2
Second Line :
City : COLUMBUS
State : WI
Zip : 53925-2604
Country : US
Telephone Number : 608-606-3153
Fax Number :
Authorized Official
Title or Position : BEHAVIOR HEALTH THERAPIST
Name : ASHLEY VOGEL
Credential : LCSW
Telephone Number : 608-606-3153
Provider Enumeration Date : 05/20/2025
Last Update Date : 05/20/2025

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Directions to “SAGEWOOD HEALING, LLC ” Practice Location

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