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General NPI Number Information
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NPI Number | 1750217402
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Entity Type | Organization
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Legal Business Name | SAGE MEADOWS MENTAL HEALTH PLLC
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Dates
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Enumeration Date | 06/22/2026
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Last Update Date | 06/22/2026
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Provider Practice Location Address
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Address Line | 10 W BROADWAY STE 700
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City | SALT LAKE CITY
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State | UT
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Zip | 84101-2060
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Country | US
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Telephone | 801-876-5634
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Fax | 801-907-7323
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Provider Business Mailing Address
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Address Line | 9212 FOX RUN AVE
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City | BATON ROUGE
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State | LA
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Zip | 70808-8107
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Country | US
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Telephone | 225-276-0144
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Fax | 801-907-7323
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Authorized Official
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Title or Position | OWNER/ PROVIDER
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Name | MRS. ERICA CHUSTZ
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Credential | PA-C
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Telephone | 801-876-5634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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