MEDICARE: SAXIFRAGE COUNSELING, 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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1972310811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAXIFRAGE COUNSELING, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1
Second Line	:
City	:	BUENA VISTA
State	:	CO
Zip	:	81211-0001
Country	:	US
Telephone Number	:	719-581-9720
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 E MAIN ST STE 205
Second Line	:
City	:	BUENA VISTA
State	:	CO
Zip	:	81211-5011
Country	:	US
Telephone Number	:	719-581-9720
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KARI VANDERBURG
Credential	:	LPC
Telephone Number	:	719-581-9720

Provider Enumeration Date	:	12/13/2024
Last Update Date	:	12/13/2024

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Directions to “SAXIFRAGE COUNSELING, LLC ” Practice Location

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