Provider Demographics
NPI:1477850360
Name:FREECHILD, SAGE (MA, LMHC)
Entity Type:Individual
Prefix:MS
First Name:SAGE
Middle Name:
Last Name:FREECHILD
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:749 WENDELL RD
Mailing Address - Street 2:
Mailing Address - City:SHUTESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01072-9733
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:749 WENDELL RD
Practice Address - Street 2:
Practice Address - City:SHUTESBURY
Practice Address - State:MA
Practice Address - Zip Code:01072-9733
Practice Address - Country:US
Practice Address - Phone:413-367-2270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1944101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health