Blue Sage Wellness, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BLUE SAGE WELLNESS, LLC

Practice address

18256 E Williams Field Rd
Gilbert, AZ 85295-6801

Phone

(480) 356-4370

NPI assigned

Nov 18, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Lisa Hold, MASTERS/CIOUNSELING

Title

Managing Member

Phone

(480) 356-4370

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605744000000",
    "number": "1952904443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18256 E WILLIAMS FIELD RD STE 6",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852956808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18256 E WILLIAMS FIELD RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852956801",
            "telephone_number": "480-356-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SAGE WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A",
        "authorized_official_last_name": "HOLD",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "480-356-4370",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MASTERS/CIOUNSELING"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.