Individual provider Active NPI

Sarah Walgenbach, AA, CAC II

  • Professional Counselor
  • Colorado Springs, CO
National Provider Identifier
1659713832
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0016658 Issued in CO
Practice address
1795 Jet Wing Dr
Colorado Springs, CO 80916-2332
Phone
(719) 572-6100
NPI assigned
Jul 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X ACB-7621 CO
Professional Counselor 101YP2500X LPC.0016658 CO Primary

Addresses

Primary practice location

1795 Jet Wing Dr
Colorado Springs, CO 80916-2332

Mailing address

1795 Jet Wing Dr
Colorado Springs, CO 80916-2332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240202001867 CO Practitioner - Mental Health Counselor 8527411800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
ACB-7621COMDAddiction (Substance Use Disorder) Counselor
LPC.0016658COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Diversus Health Inc CurrentSince Jan 1, 2024 Accepting new patients
Diversus Health Inc Current Accepting new patients
Diversus Health Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

460 County Road 43
Ste 7
Bailey, CO 80421
Phone (303) 838-5013

328 10th St
Calhan, CO 80808

875 W Moreno Ave
Colorado Springs, CO 80905
Phone (719) 572-6200

179 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 572-6300

1795 Jet Wing Dr
Colorado Springs, CO 80916
Phone (719) 572-6111

6208 Lehman Dr
Colorado Springs, CO 80918
Phone (719) 572-6133

220 Ruskin Dr
Colorado Springs, CO 80910
Phone (719) 572-6150

413 Security Blvd
Colorado Springs, CO 80911

115 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 572-6340

18401 Highway 24
Ste 119
Woodland Park, CO 80863

Organizations & group practices 3

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": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1659713832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 JET WING DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809162332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 JET WING DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809162332",
            "telephone_number": "719-572-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALGENBACH",
        "first_name": "SARAH",
        "credential": "AA, CAC II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-29",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACB-7621",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0016658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.