Provider Demographics
NPI:1306227830
Name:SAGE COUNSELING, INC.
Entity Type:Organization
Organization Name:SAGE COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-649-3352
Mailing Address - Street 1:1830 S. ALMA SCHOOL ROAD, SUITE 101
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6610 N. 47TH AVENUE, SUITES 6, 7 & 8
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301
Practice Address - Country:US
Practice Address - Phone:480-649-3352
Practice Address - Fax:480-649-3358
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAGE COUNSELING, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-10
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health