Healthcare Provider Details

I. General information

NPI: 1922572015
Provider Name (Legal Business Name): SAGE SUPPORTIVE SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2019
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1770 SAINT JAMES PL STE 206
HOUSTON TX
77056-3432
US

IV. Provider business mailing address

PO BOX 321022
HOUSTON TX
77221-1022
US

V. Phone/Fax

Practice location:
  • Phone: 713-369-4342
  • Fax: 713-369-4342
Mailing address:
  • Phone: 713-369-4342
  • Fax: 713-369-4342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BIANCA JONES
Title or Position: OWNER
Credential: PHD
Phone: 713-369-4342