Healthcare Provider Details

I. General information

NPI: 1629819578
Provider Name (Legal Business Name): ASCENDANCY MENTAL AND BEHAVIORAL HEALTH SERVICES, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3802 AVENUE B
SCOTTSBLUFF NE
69361-4653
US

IV. Provider business mailing address

3802 AVENUE B
SCOTTSBLUFF NE
69361-4653
US

V. Phone/Fax

Practice location:
  • Phone: 308-635-2800
  • Fax: 308-251-6608
Mailing address:
  • Phone: 308-635-2800
  • Fax: 308-251-6608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: SARAH GRACE WALGREN
Title or Position: OWNER
Credential: LIMHP
Phone: 619-323-6752