Healthcare Provider Details

I. General information

NPI: 1114719887
Provider Name (Legal Business Name): SAGEWOOD HEALING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 PARK AVE STE 2
COLUMBUS WI
53925-2604
US

IV. Provider business mailing address

PO BOX 42
COLUMBUS WI
53925-0042
US

V. Phone/Fax

Practice location:
  • Phone: 608-606-3153
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: ASHLEY VOGEL
Title or Position: BEHAVIOR HEALTH THERAPIST
Credential: LCSW
Phone: 608-606-3153