Provider Demographics
NPI:1659028702
Name:SAGE THERAPY LLC
Entity Type:Organization
Organization Name:SAGE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUCKENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LPC, MCAP
Authorized Official - Phone:386-214-0297
Mailing Address - Street 1:1336 HIGH CT
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-5533
Mailing Address - Country:US
Mailing Address - Phone:386-214-0297
Mailing Address - Fax:
Practice Address - Street 1:1336 HIGH CT
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-5533
Practice Address - Country:US
Practice Address - Phone:386-214-0297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty