Provider Demographics
NPI:1316616246
Name:SAGE ELITE HEALING LLC
Entity type:Organization
Organization Name:SAGE ELITE HEALING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER / CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN STEENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:720-460-7660
Mailing Address - Street 1:P.O. BOX 271327
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-5026
Mailing Address - Country:US
Mailing Address - Phone:720-460-7660
Mailing Address - Fax:303-648-6686
Practice Address - Street 1:1495 CANYON BLVD
Practice Address - Street 2:STE 200B
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5367
Practice Address - Country:US
Practice Address - Phone:720-460-7660
Practice Address - Fax:303-648-6686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty