Provider Demographics
NPI:1295386035
Name:SAGE WELLNESS & CONSULTING PLLC
Entity Type:Organization
Organization Name:SAGE WELLNESS & CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:NORTEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:845-270-1178
Mailing Address - Street 1:5500 COLUMBIA PIKE APT 106
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-3188
Mailing Address - Country:US
Mailing Address - Phone:845-270-1178
Mailing Address - Fax:
Practice Address - Street 1:709 PENDLETON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1820
Practice Address - Country:US
Practice Address - Phone:845-270-1178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty