Provider Demographics
NPI:1881001709
Name:SAGE SPEECH & LEARNING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:SAGE SPEECH & LEARNING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MSC, CCC-SLP
Authorized Official - Phone:404-245-7981
Mailing Address - Street 1:1885 WITHMERE WAY
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-2836
Mailing Address - Country:US
Mailing Address - Phone:404-245-7981
Mailing Address - Fax:404-891-6440
Practice Address - Street 1:1885 WITHMERE WAY
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-2836
Practice Address - Country:US
Practice Address - Phone:404-245-7981
Practice Address - Fax:404-891-6440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007147235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003125824AMedicaid