| Sage Elite Healing | |
|
1495 Canyon Blvd Ste 200b Boulder CO 80302-5367 | |
| (720) 460-7660 | |
| (303) 648-6686 |
| Full Name | Sage Elite Healing |
|---|---|
| Speciality | Social Worker |
| Location | 1495 Canyon Blvd, Boulder, Colorado |
| Authorized Official Name and Position | Mark Van Steenberg (FOUNDER / CEO) |
| Authorized Official Contact | 7204607660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sage Elite Healing P.o. Box 271327 Louisville CO 80027-5026 Ph: (720) 460-7660 | Sage Elite Healing 1495 Canyon Blvd Ste 200b Boulder CO 80302-5367 Ph: (720) 460-7660 |
| NPI Number | 1316616246 |
|---|---|
| Provider Enumeration Date | 09/13/2021 |
| Last Update Date | 12/20/2022 |
| Certification Date | 12/20/2022 |
| Medicare PECOS PAC ID | 8123402013 |
|---|---|
| Medicare Enrollment ID | O20220825003671 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316616246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mark Van Steenberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093101602 PECOS PAC ID: 0941684831 Enrollment ID: I20220825003735 |
| Provider Name | Suzanne C Bidwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790322246 PECOS PAC ID: 8426443433 Enrollment ID: I20230228000032 |
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