Healthcare Provider Details

I. General information

NPI: 1578141313
Provider Name (Legal Business Name): SAGE THERAPY COLLECTIVE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 I ST NW STE 300
WASHINGTON DC
20006-2423
US

IV. Provider business mailing address

1725 I ST NW STE 300
WASHINGTON DC
20006-2423
US

V. Phone/Fax

Practice location:
  • Phone: 202-449-9262
  • Fax: 703-239-7188
Mailing address:
  • Phone: 202-449-9262
  • Fax: 703-239-7188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. HUMA SIKANDAR FATAKIA
Title or Position: FOUNDER & CEO
Credential: LPC
Phone: 202-449-9262