Provider Demographics
NPI:1710045547
Name:SAGE, ARLENE B (LCSW)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:B
Last Name:SAGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13660 JOG RD
Mailing Address - Street 2:SUITE B3
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-3806
Mailing Address - Country:US
Mailing Address - Phone:561-496-5144
Mailing Address - Fax:561-496-5201
Practice Address - Street 1:13660 JOG RD
Practice Address - Street 2:SUITE B3
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-3806
Practice Address - Country:US
Practice Address - Phone:561-496-5144
Practice Address - Fax:561-496-5201
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW25461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ4165ZMedicare ID - Type Unspecified