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 1:1273 METROPOLITAN AVE SE UNIT 17661
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-8009
Mailing Address - Country:US
Mailing Address - Phone:404-245-7981
Mailing Address - Fax:404-891-6440
Practice Address - Street 1:8735 DUNWOODY PL STE 3
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30350-2995
Practice Address - Country:US
Practice Address - Phone:404-245-7981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2024-04-22
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