NPI Code Details Logo

NPI 1609781475

NPI 1609781475 : SAGE & SUMMIT PSYCHIATRY : GRAND JUNCTION, CO

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1609781475
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    SAGE & SUMMIT PSYCHIATRY 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/17/2026
-----------------------------------------------------
    Last Update Date     |    08/17/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2140 N 12TH ST 
-----------------------------------------------------
    City                 |    GRAND JUNCTION
-----------------------------------------------------
    State                |    CO
-----------------------------------------------------
    Zip                  |    81501-2916
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    970-579-0003
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1010 RICO CT 
-----------------------------------------------------
    City                 |    GRAND JUNCTION
-----------------------------------------------------
    State                |    CO
-----------------------------------------------------
    Zip                  |    81506-8273
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    NURSE PRACTITIONER
-----------------------------------------------------
    Name                 |     NICOLE  FRETTERD 
-----------------------------------------------------
    Credential           |    MSN, PMHNP-BC
-----------------------------------------------------
    Telephone            |    970-683-8281
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QM0850X
-----------------------------------------------------
    Taxonomy Name        |    Adult Mental Health Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.