Healthcare Provider Details

I. General information

NPI: 1124436654
Provider Name (Legal Business Name): SAGE COUNSELING CONSULTANTS, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2014
Last Update Date: 02/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2670 N COLUMBUS ST SUITE K
LANCASTER OH
43130-8408
US

IV. Provider business mailing address

2670 N COLUMBUS ST SUITE K
LANCASTER OH
43130-8408
US

V. Phone/Fax

Practice location:
  • Phone: 740-974-5832
  • Fax: 740-277-6555
Mailing address:
  • Phone: 740-974-5832
  • Fax: 740-277-6555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ROCHELLE ELLIS
Title or Position: OWNER
Credential: MSW, LISW-S
Phone: 740-974-5832