MEDICARE: SAGEBRUSH MENTAL HEALTH, LLC

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
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1528919891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAGEBRUSH MENTAL HEALTH, LLC

Provider Business Mailing Address
First Line	:	714 RIVERVIEW AVE
Second Line	:
City	:	LOGAN
State	:	UT
Zip	:	84321-4730
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1532 N 160 W STE 110
Second Line	:
City	:	LOGAN
State	:	UT
Zip	:	84341-3197
Country	:	US
Telephone Number	:	435-227-5113
Fax Number	:

Authorized Official
Title or Position	:	MENTAL HEALTH THERAPIST
Name	:	AUTUMN ABBOTT
Credential	:	LCSW
Telephone Number	:	435-227-5113

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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