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General NPI Number Information
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NPI Number | 1114719887
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Entity Type | Organization
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Legal Business Name | SAGEWOOD HEALING, LLC
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 635 PARK AVE STE 2
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City | COLUMBUS
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State | WI
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Zip | 53925-2604
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Country | US
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Telephone | 608-606-3153
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 42
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City | COLUMBUS
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State | WI
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Zip | 53925-0042
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BEHAVIOR HEALTH THERAPIST
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Name | ASHLEY VOGEL
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Credential | LCSW
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Telephone | 608-606-3153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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