Provider Demographics
NPI:1508628645
Name:STEVENS, SAGE CADIN (LSW)
Entity Type:Individual
Prefix:
First Name:SAGE
Middle Name:CADIN
Last Name:STEVENS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2363 CHIPMUNK LN
Mailing Address - Street 2:
Mailing Address - City:SECANE
Mailing Address - State:PA
Mailing Address - Zip Code:19018-4505
Mailing Address - Country:US
Mailing Address - Phone:973-796-8191
Mailing Address - Fax:
Practice Address - Street 1:2363 CHIPMUNK LN
Practice Address - Street 2:
Practice Address - City:SECANE
Practice Address - State:PA
Practice Address - Zip Code:19018-4505
Practice Address - Country:US
Practice Address - Phone:973-796-8191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW141113104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker