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General NPI Number Information
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NPI Number | 1649638602
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Entity Type | Individual
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Provider Name | JAY SAGONA LINDSAY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 02/05/2016
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Last Update Date | 02/05/2016
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Provider Practice Location Address
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Address Line | 357 MCCASLIN BLVD
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City | LOUISVILLE
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State | CO
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Zip | 80027-2941
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Country | US
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Telephone | 303-545-9828
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Fax | 720-874-9644
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Provider Business Mailing Address
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Address Line | 357 MCCASLIN BLVD
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City | LOUISVILLE
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State | CO
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Zip | 80027-2941
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Country | US
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Telephone | 303-545-9828
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Fax | 720-874-9644
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 675
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 045
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License Number State | CO
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