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NPI Code Detail

MEDICARE: SAGED PSYCHOTHERAPY INC.

MEDICARE: SAGED PSYCHOTHERAPY INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1417840703
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAGED PSYCHOTHERAPY INC.
Provider Business Mailing Address
First Line : 1518 E BOWEN BLVD
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-9767
Country : US
Telephone Number : 501-951-1444
Fax Number :
Provider Business Practice Location Address
First Line : 901 S RAINBOW RD
Second Line :
City : ROGERS
State : AR
Zip : 72758-1637
Country : US
Telephone Number : 501-951-1444
Fax Number :
Authorized Official
Title or Position : LICENSED PROFESSIONAL COUNSELOR
Name : ERIC DINGLER
Credential : LPC
Telephone Number : 501-951-1444
Provider Enumeration Date : 06/03/2025
Last Update Date : 06/04/2025

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