Provider Demographics
NPI:1548017247
Name:SASA PLLC
Entity type:Organization
Organization Name:SASA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:719-510-7056
Mailing Address - Street 1:PO BOX 351
Mailing Address - Street 2:
Mailing Address - City:CONVOY
Mailing Address - State:OH
Mailing Address - Zip Code:45832-0351
Mailing Address - Country:US
Mailing Address - Phone:719-510-7056
Mailing Address - Fax:614-656-6614
Practice Address - Street 1:3204 N ACADEMY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5163
Practice Address - Country:US
Practice Address - Phone:197-510-7056
Practice Address - Fax:614-656-6614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty