Healthcare Provider Details

I. General information

NPI: 1417876061
Provider Name (Legal Business Name): SAGE MCCLURE MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST YAWKEY SUITE 4F
BOSTON MA
02114
US

IV. Provider business mailing address

595 MAIN ST # 301
MEDFORD MA
02155-6597
US

V. Phone/Fax

Practice location:
  • Phone: 978-882-6742
  • Fax:
Mailing address:
  • Phone: 978-467-5256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License NumberGC10072
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: