Provider Demographics
NPI:1417247263
Name:SAGE, CHERRIE A (BS)
Entity Type:Individual
Prefix:MRS
First Name:CHERRIE
Middle Name:A
Last Name:SAGE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607B S POLK ST
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-3968
Mailing Address - Country:US
Mailing Address - Phone:931-461-1360
Mailing Address - Fax:931-461-1372
Practice Address - Street 1:607B S POLK ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-3968
Practice Address - Country:US
Practice Address - Phone:931-461-1360
Practice Address - Fax:931-461-1372
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health