Healthcare Provider Details

I. General information

NPI: 1083550503
Provider Name (Legal Business Name): SAGE & SOL COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 BIRCHALL RD
TOLEDO OH
43612-1672
US

IV. Provider business mailing address

9015 LOGGERS RUN
NEWPORT MI
48166-7840
US

V. Phone/Fax

Practice location:
  • Phone: 419-709-2507
  • Fax:
Mailing address:
  • Phone: 419-709-2507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JAISHA HOLMES
Title or Position: OWNER/ THERAPIST
Credential: LISW-S
Phone: 419-709-2507