Provider Demographics
NPI:1184241036
Name:SAGE COUNSELING AND WELLNESS SERVICES LLC
Entity type:Organization
Organization Name:SAGE COUNSELING AND WELLNESS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVISKI
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:419-350-0474
Mailing Address - Street 1:5144 SADDLECREEK RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-2733
Mailing Address - Country:US
Mailing Address - Phone:419-350-0474
Mailing Address - Fax:
Practice Address - Street 1:1705 INDIAN WOOD CIR STE 200
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-4046
Practice Address - Country:US
Practice Address - Phone:419-969-7243
Practice Address - Fax:419-740-1977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty