Organization Active NPI

Sasa PLLC

  • Marriage & Family Therapist
  • Colorado Springs, CO
National Provider Identifier
1548017247
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
SASA PLLC
Practice address
3204 N Academy Blvd Ste 200
Colorado Springs, CO 80917-5163
Phone
(197) 510-7056
Fax
(614) 656-6614
NPI assigned
May 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Colleen Evans, LMFTNPI 1427416445
Title
Owner/Member/Manager
Phone
(719) 510-7056

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

3204 N Academy Blvd Ste 200
Colorado Springs, CO 80917-5163

Mailing address

PO Box 351
Convoy, OH 45832-0351
Phone (719) 510-7056

Other names 1

  • Soulmates And Self-Actualization Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250122000427 CO Part B Supplier - Clinic/Group Practice 2567991433 Receives reassigned benefits from 1 practitioner
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Locations

3204 N Academy Blvd
Ste 200
Colorado Springs, CO 80917
Phone (719) 510-7056

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1548017247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 351",
            "city": "CONVOY",
            "state": "OH",
            "postal_code": "458320351",
            "telephone_number": "719-510-7056",
            "fax_number": "614-656-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 N ACADEMY BLVD STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175163",
            "telephone_number": "197-510-7056",
            "fax_number": "614-656-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SASA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "OWNER/MEMBER/MANAGER",
        "authorized_official_telephone_number": "719-510-7056",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soulmates And Self-Actualization",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.