Provider Demographics
NPI:1568872596
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:MS, LISAC
Authorized Official - Phone:480-649-3352
Mailing Address - Street 1:1830 S ALMA SCHOOL RD STE 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:480-649-3352
Mailing Address - Fax:480-649-3358
Practice Address - Street 1:4435 S RURAL RD STE 5
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7059
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:2014-04-29
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC5956251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health