Healthcare Provider Details
I. General information
NPI: 1821905373
Provider Name (Legal Business Name): SAGE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
210 COPPER RIDGE RD
SOUTHINGTON CT
06489-4607
US
IV. Provider business mailing address
2389 MAIN ST STE 100
GLASTONBURY CT
06033-4617
US
V. Phone/Fax
- Phone: 475-381-3149
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHANIE
CIARDELLA
Title or Position: LCSW
Credential:
Phone: 475-381-3149