Provider Demographics
NPI:1043776578
Name:SAGEMIND LLC
Entity Type:Organization
Organization Name:SAGEMIND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:ALADDIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OSSORIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-918-7195
Mailing Address - Street 1:21 WORCESTER SQ APT 1
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2939
Mailing Address - Country:US
Mailing Address - Phone:671-918-7195
Mailing Address - Fax:
Practice Address - Street 1:21 WORCESTER SQ APT 1
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2939
Practice Address - Country:US
Practice Address - Phone:671-918-7195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty