Provider Demographics
NPI:1578030789
Name:SAGO, ADRIAN CHEARELL (LPC)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:CHEARELL
Last Name:SAGO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3729 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30337-3544
Mailing Address - Country:US
Mailing Address - Phone:404-827-8140
Mailing Address - Fax:404-346-3473
Practice Address - Street 1:3729 MAIN ST
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30337-3544
Practice Address - Country:US
Practice Address - Phone:404-827-8140
Practice Address - Fax:404-346-3473
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC011326101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional