Provider Demographics
NPI:1649038167
Name:MAX A STAGER
Entity type:Organization
Organization Name:MAX A STAGER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MAX
Authorized Official - Middle Name:A
Authorized Official - Last Name:STAGER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-460-4185
Mailing Address - Street 1:1540 S 8TH ST # 38145
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-1933
Mailing Address - Country:US
Mailing Address - Phone:719-460-4185
Mailing Address - Fax:719-900-1838
Practice Address - Street 1:1540 S 8TH ST # 38145
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-1933
Practice Address - Country:US
Practice Address - Phone:719-460-4185
Practice Address - Fax:719-900-1838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-08
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty