Provider Demographics
NPI:1285837609
Name:SAGE-MCLEAN, PATRICIA S (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:S
Last Name:SAGE-MCLEAN
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:S
Other - Last Name:SAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:143 MCLEAN LN
Mailing Address - Street 2:
Mailing Address - City:GREENE
Mailing Address - State:NY
Mailing Address - Zip Code:13778-2214
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20-24 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903-1710
Practice Address - Country:US
Practice Address - Phone:607-251-2300
Practice Address - Fax:607-251-2314
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NY0733531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)