Provider Demographics
NPI:1225746787
Name:ANGELISANTI, SAGE
Entity Type:Individual
Prefix:
First Name:SAGE
Middle Name:
Last Name:ANGELISANTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 GLENFIELD CT
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19609-2145
Mailing Address - Country:US
Mailing Address - Phone:610-743-0704
Mailing Address - Fax:
Practice Address - Street 1:4 PARK PLZ
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1398
Practice Address - Country:US
Practice Address - Phone:610-743-0704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor