Active NPI
Gina Sagona
- Professional Counselor
- Pueblo, CO
National Provider Identifier
1033768684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC.0017810
- Practice address
- 1012 W Abriendo Ave
Pueblo, CO 81004-1128 - Phone
- (719) 545-2746
- NPI assigned
- Sep 6, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPCC.0016998 | CO | |
| Professional Counselor | 101YP2500X | |||
| Professional Counselor | 101YP2500X | LPC.0017810 | CO | Primary |
Addresses
Primary practice location
1012 W Abriendo Ave
Pueblo, CO 81004-1128
Mailing address
41 Montebello Rd Ste 204
Pueblo, CO 81001-1379
Phone (719) 423-1341
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPCC.0016998 | CO | MD | Counselor |
| LPC.0017810 | CO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affinity Therapy Services LLC | Professional | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639440000000",
"number": "1033768684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 MONTEBELLO RD STE 204",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810011379",
"telephone_number": "719-423-1341",
"fax_number": "719-545-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1012 W ABRIENDO AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810041128",
"telephone_number": "719-545-2746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAGONA",
"first_name": "GINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-06",
"last_updated": "2021-12-14",
"certification_date": "2021-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CO",
"license": "LPCC.0016998",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "LPC.0017810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.