Healthcare Provider Details

I. General information

NPI: 1821921875
Provider Name (Legal Business Name): SAGE & SOUL PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 MAPLE AVE
RED BANK NJ
07701-1734
US

IV. Provider business mailing address

305 MARK TWAIN WAY
MAHWAH NJ
07430-3473
US

V. Phone/Fax

Practice location:
  • Phone: 732-786-3441
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: NOEL RAPP
Title or Position: OWNER, CLINICIAN
Credential: LCSW, SAP
Phone: 201-783-3383