Healthcare Provider Details

I. General information

NPI: 1902679855
Provider Name (Legal Business Name): SAGE ASPLUND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2023
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 SALAZAR RD
TAOS NM
87571-8231
US

IV. Provider business mailing address

124 VERDOLAGA RD
EL PRADO NM
87529-7548
US

V. Phone/Fax

Practice location:
  • Phone: 575-758-8082
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberSWB-2025-0764
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: